Organization
EXTENDED FAMILY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRICA JOLIVETTE (DIRECTOR/OWNER)
(337) 280-2621
Entity
Organization
Contact information
Practice address
201 LEONARD ST, BREAUX BRIDGE, LA 70517-5199
(337) 507-3819
(337) 332-0072
Mailing address
201 LEONARD ST, BREAUX BRIDGE, LA 70517-5199
(337) 507-3819
(337) 332-0072
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
PCA 15114
LA
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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