Organization
EXTENDED FAMILY CARE LLC
Active
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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