Organization
HEALTHY SCHOOLS LOUISIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD BOSELLI JR. (PRESIDENT)
(904) 379-5997
Entity
Organization
Contact information
Practice address
1801 FAIRFIELD AVE STE 101, SHREVEPORT, LA 71101-4457
(571) 289-1765
Mailing address
3546 SAINT JOHNS BLUFF RD S UNIT 113, JACKSONVILLE, FL 32224-2714
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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