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Organization

GRACE AND GLORY ADHC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JENNIIFER LEANETTE CARLIN (ADMINISTRATOR)
(225) 926-4241
Entity
Organization

Contact information

Practice address
2127 BEAUMONT DR, BATON ROUGE, LA 70806-1436
(225) 926-4241
(225) 926-7223
Mailing address
2127 BEAUMONT DR, BATON ROUGE, LA 70806-1436
(225) 926-4241
(225) 926-7223

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
2684
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1438651
ADULT DAY HEALTH CARE
LA
Enumeration date
04/26/2007
Last updated
08/22/2020
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