Organization
BAYOU HOME BUREAU CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANETTA MARTIN (OWNER)
(318) 556-0043
Entity
Organization
Contact information
Practice address
8057 WILLIARD RD, SAME, BASTROP, LA 71220-8939
(318) 556-0043
(318) 556-3633
Mailing address
8057 WILLIARD RD, P. O. BOX 561, BASTROP, LA 71220-8939
(318) 556-0043
(318) 556-3633
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
1564761
LA
305R00000X
Preferred Provider Organization
Primary
1564761
LA
Other
Enumeration date
10/01/2007
Last updated
09/06/2023
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