Organization
PROACTIVE RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY DARNELL SPURLOCK (OWNER)
(225) 328-6800
Entity
Organization
Contact information
Practice address
6547 N FOSTER DR, SUITE A, BATON ROUGE, LA 70811-6115
(225) 328-6800
Mailing address
PO BOX 87356, BATON ROUGE, LA 70879-8356
(225) 328-6800
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
27029
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1803901
—
LA
05
—
1806897
—
LA
Enumeration date
11/18/2008
Last updated
12/22/2009
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