Organization
GIFTED HEART SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSIE POLEDOR (CHIEF ADMINISTRATOR)
(337) 394-1799
Entity
Organization
Contact information
Practice address
717 N MAIN ST, SAINT MARTINVILLE, LA 70582-4124
(337) 394-1799
(337) 394-1799
Mailing address
717 N MAIN ST, SAINT MARTINVILLE, LA 70582-4124
(337) 394-1799
(337) 394-1799
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
11451
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1472077
—
LA
Enumeration date
03/23/2007
Last updated
07/27/2007
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