Individual
ELVA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13304 BRIARBEND AVE, BATON ROUGE, LA 70810-5111
(225) 324-4218
Mailing address
13304 BRIARBEND AVE, BATON ROUGE, LA 70810-5111
(225) 324-4218
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
LA
Enumeration date
09/10/2021
Last updated
09/10/2021
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