Organization
GREATER FELLOWSHIP OUTREACH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEISHA DAISY (OWNER-DIRECTOR)
(225) 931-3571
Entity
Organization
Contact information
Practice address
11752 S HARRELLS FERRY RD, SUITE E, BATON ROUGE, LA 70816-2387
(225) 292-9628
(225) 292-9623
Mailing address
11752 S HARRELLS FERRY RD, SUITE E, BATON ROUGE, LA 70816-2387
(225) 292-9628
(225) 292-9623
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
7934
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1432504
PERSONAL CARE ATTENDANT
LA
Enumeration date
03/08/2007
Last updated
08/22/2020
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