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Organization

TOTAL DIVINE CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ARIELLE MCNEAL (OWNER)
(318) 267-5190
Entity
Organization

Contact information

Practice address
1840 NORTH WASHINGTON STREET, BASTROP, LA 71220
(318) 283-1010
Mailing address
1840 NORTH WASHINGTON STREET, BASTROP, LA 71220

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
251S00000X
LA
Enumeration date
04/27/2017
Last updated
04/27/2017
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