Organization
EXTENDED FAMILY CARE LLC
Active
Other names
Extended Family Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ADA MAIRE JOHNSON (OWNER/OPERATOR)
(504) 231-1060
Entity
Organization
Contact information
Practice address
3309 ASHLEY DR, 3309 ASHLEY, VIOLET, LA 70092-2837
(504) 231-1060
Mailing address
PO BOX 353, 3309 ASHLEY DR, VIOLET, LA 70092-0353
(504) 231-1060
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
LA
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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