Organization
MADE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLAY A DOUGLAS AA, AAS, BA, MSW (OWNER/CEO)
(504) 221-5003
Entity
Organization
Contact information
Practice address
5605 6TH ST, APT B, VIOLET, LA 70092-3083
(504) 221-5003
Mailing address
PO BOX 224, VIOLET, LA 70092-0224
(504) 221-5003
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
LA
251S00000X
Community/Behavioral Health Agency
—
LA
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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