Organization
PARISHES SUPPORTIVE LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COREY VINING (CFO)
(985) 386-0898
Entity
Organization
Contact information
Practice address
112 S 3RD ST, PONCHATOULA, LA 70454-2602
(985) 386-0898
(985) 370-5788
Mailing address
112 S 3RD ST, PONCHATOULA, LA 70454-2602
(985) 386-0898
(985) 370-5788
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
10583
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1173487
—
LA
Enumeration date
05/14/2007
Last updated
08/22/2020
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