Organization
LDH FAMILY AFFAIR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EBONY ROUSSELL (OWNER)
(504) 715-8726
Entity
Organization
Contact information
Practice address
931 CARMADELLE ST, MARRERO, LA 70072-2641
(504) 715-8726
(504) 407-3901
Mailing address
931 CARMADELLE ST, MARRERO, LA 70072-2641
(504) 715-8726
(504) 407-3901
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
172A00000X
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598262883
—
LA
Enumeration date
05/25/2018
Last updated
05/25/2018
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