Organization
WANDA KAYE'S HEART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUMAKA GOUCH (ADMINISTRATOR)
(337) 704-7094
Entity
Organization
Contact information
Practice address
139B JAMES COMEAUX RD # 563, LAFAYETTE, LA 70508-3255
(337) 704-7094
Mailing address
139B JAMES COMEAUX RD # 563, LAFAYETTE, LA 70508-3255
(337) 704-7094
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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