Organization
CD&J MANAGEMENT, LLC
Active
Other names
Optimum Personal Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DELILAH M BROUSSARD (EXECUTIVE DIRECTOR)
(337) 593-8444
Entity
Organization
Contact information
Practice address
920 W PINHOOK RD, SUITE 226, LAFAYETTE, LA 70503-2455
(337) 593-8444
(337) 593-9966
Mailing address
920 W PINHOOK RD, SUITE 226, LAFAYETTE, LA 70503-2455
(337) 593-8444
(337) 593-9966
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
11117
LA
302F00000X
Exclusive Provider Organization
12067
LA
302F00000X
Exclusive Provider Organization
12068
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1466093
—
LA
05
—
1776785
—
LA
05
—
1778371
—
LA
Enumeration date
08/17/2006
Last updated
09/13/2008
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