Organization
EXECTIONAL CLIENT CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JENNY KIM CHOI (PROGRAM DIRECTOR)
(318) 242-0041
Entity
Organization
Contact information
Practice address
919 N TRENTON ST STE 101, RUSTON, LA 71270-3375
(318) 242-0041
(318) 513-1016
Mailing address
919 N TRENTON ST STE 101, RUSTON, LA 71270-3375
(318) 242-0041
(318) 513-1016
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PCA 6660
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1706299
—
LA
Enumeration date
12/27/2007
Last updated
12/27/2007
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