Organization
EXCEPTIONAL CLIENT CARE SERVICES II L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES RAY JOHNSON (OWNER)
(318) 286-5935
Entity
Organization
Contact information
Practice address
919 N TRENTON ST STE 101, RUSTON, LA 71270-3374
(318) 242-0041
(318) 513-1016
Mailing address
919 N TRENTON ST STE 101, RUSTON, LA 71270-3374
(318) 242-0041
(318) 513-1016
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PCA 6660
LA
251E00000X
Home Health Agency
SIL 6677
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1334294
—
LA
05
—
1450260
—
LA
05
—
1706299
—
LA
Enumeration date
02/27/2007
Last updated
08/06/2007
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