Organization
NORTHEAST LA HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENDA FAYE SMITH (PRESIDENT)
(318) 649-0653
Entity
Organization
Contact information
Practice address
8636 HWY 165 S, COLUMBIA, LA 71418
(318) 649-0653
Mailing address
PO BOX 96, CLARKS, LA 71415-0096
(318) 649-0653
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
10414
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1469700
—
LA
Enumeration date
12/13/2006
Last updated
06/23/2008
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