Organization
LIGHT OF LIFE HEALTH AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYUNA D SMITH (HR REPRESENTATIVE)
(318) 658-0362
Entity
Organization
Contact information
Practice address
9730 BAIRD RD APT 822, SHREVEPORT, LA 71118-3821
(318) 349-0778
Mailing address
9730 BAIRD RD APT 822, SHREVEPORT, LA 71118-3821
(318) 349-0778
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/30/2021
Last updated
10/19/2021
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