Organization
HEALTH SOURCE ONE PRIVATE DUTY & STAFFING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VANESSA J. SALEEM (DIRECTOR OF PRIVATE DUTY SERVICES)
(225) 293-7590
Entity
Organization
Contact information
Practice address
11715 BRICKSOME AVE, SUITE A-3, BATON ROUGE, LA 70816-2307
(225) 293-7590
(225) 293-7592
Mailing address
11715 BRICKSOME AVE, SUITE A-3, BATON ROUGE, LA 70816-2307
(225) 293-7590
(225) 293-7592
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
6897
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PCA 6897
PCA LICENSURE
LA
Enumeration date
06/26/2007
Last updated
11/05/2008
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