Organization
LIFE SOURCE SERVICES, LLC
Active
Other names
Life Source Services Baton Rouge
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RANDY BELTON (AUTHORIZED REPRESENTATIVE)
(601) 709-1408
Entity
Organization
Contact information
Practice address
3049 S SHERWOOD FOREST BLVD, SUITE 100, BATON ROUGE, LA 70816-2277
(225) 291-9421
(225) 291-9743
Mailing address
3049 S SHERWOOD FOREST BLVD, SUITE 100, BATON ROUGE, LA 70816-2277
(225) 291-9421
(225) 291-9743
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
148
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1581071
—
LA
Enumeration date
05/02/2006
Last updated
08/07/2007
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