Organization
ACTIVITIES OD DAILY LIVING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STELLA WILTZ (OWNER/ADMINISTRATOR)
(337) 332-1810
Entity
Organization
Contact information
Practice address
400 RICHARD ST, BREAUX BRIDGE, LA 70517-6039
(337) 332-1810
(337) 332-3300
Mailing address
400 RICHARD ST, BREAUX BRIDGE, LA 70517-6039
(337) 332-1810
(337) 332-3300
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
11226
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306382817
—
LA
Enumeration date
01/09/2017
Last updated
01/30/2017
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