Organization
A-1 CUSTOMIZED COMPANION SERVICES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS VALERIE MELANCON (OWENER)
(504) 913-5452
Entity
Organization
Contact information
Practice address
2100 BELLE CHASSE HWY # C, GRETNA, LA 70053-6651
(504) 913-5452
(504) 367-6601
Mailing address
2100 BELLE CHASSE HWY # C, GRETNA, LA 70053-6651
(504) 367-6601
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
15292
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000123
—
LA
Enumeration date
12/14/2009
Last updated
12/14/2009
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