Organization
ALOE VERA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS JEFFERSON SMITH JR. (CEO)
(985) 863-5559
Entity
Organization
Contact information
Practice address
62390 JOHN SMITH RD, PEARL RIVER, LA 70452-3334
(985) 863-3212
Mailing address
62390 JOHN SMITH RD, PEARL RIVER, LA 70452-3334
(985) 863-3212
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PCA10891
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1712469
—
LA
Enumeration date
05/16/2007
Last updated
08/22/2020
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