Organization
PROMISE PRIDE ENTERPRISES INC
Active
Other names
Promise Pride Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY E WHITE REGISTERED NURSE (PROGRAM DIRECTOR ADMINISTRATOR)
(225) 774-3499
Entity
Organization
Contact information
Practice address
5100 GROOM ROAD, BAKER, LA 70714-3124
(225) 774-3385
(225) 774-7381
Mailing address
5100 GROOM ROAD, BAKER, LA 70714-3124
(225) 774-3385
(225) 774-7381
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
PCA 12774
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1191655
—
LA
01
—
1468070
WAIVER
LA
Enumeration date
08/21/2006
Last updated
08/22/2020
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