Organization
PARISHES SUPPORTIVE LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COREY VINING (CFO)
(985) 386-0898
Entity
Organization
Contact information
Practice address
112 S 3RD ST, PONCHATOULA, LA 70454-2602
(985) 386-0898
(985) 370-5788
Mailing address
112 S 3RD ST, PONCHATOULA, LA 70454-2602
(985) 386-0898
(985) 370-5788
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1465658
—
LA
Enumeration date
02/01/2008
Last updated
02/01/2008
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