Organization
EXTENDED FAMILY HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY LATHAN BATISTE MBA/MA (OWNER)
(225) 923-0203
Entity
Organization
Contact information
Practice address
9441 COMMON ST, B, BATON ROUGE, LA 70809-1463
(225) 923-0203
(225) 923-0207
Mailing address
1970 FLORIDA AVE SW, D, DENHAM SPRINGS, LA 70726-4948
(225) 664-0401
(225) 923-0207
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
20021
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20021
—
LA
Enumeration date
01/03/2008
Last updated
01/03/2008
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