Organization
ST MARTIN COUNCIL ON AGING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EARLINE J COUNTEE (DIRECTOR)
(337) 332-3063
Entity
Organization
Contact information
Practice address
511 WILD CHERRY LN, BREAUX BRIDGE, LA 70517-6021
(337) 332-3063
(337) 332-1541
Mailing address
511 WILD CHERRY LN, BREAUX BRIDGE, LA 70517-6021
(337) 332-3063
(337) 332-1541
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
PCA2672
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04010099
—
LA
05
—
1611514
—
LA
Enumeration date
02/23/2007
Last updated
08/22/2020
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