Organization
GUILLORYS SHOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIS GUILLORYS SR. (CEO)
(337) 207-5393
Entity
Organization
Contact information
Practice address
137 W MAIN, VILLE PLATTE, LA 70586
(337) 207-5393
Mailing address
626 W. LINCOLN RD, VILLE PLATTE, LA 70586
(337) 207-5393
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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