Organization
JASTAY ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA TAYLOR (OWNER)
(318) 556-3378
Entity
Organization
Contact information
Practice address
117 N WASHINGTON ST, BASTROP, LA 71220-3842
(318) 556-3378
Mailing address
117 N WASHINGTON ST, BASTROP, LA 71220-3842
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
10768
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1569275
SUPERVISED INDEPENDENT LIVING
LA
Enumeration date
06/09/2008
Last updated
06/09/2008
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