Organization
MANGHAM HOME CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IDA B GILLEY (ADMINISTRATOR)
(318) 248-2797
Entity
Organization
Contact information
Practice address
714 BROADWAY, MANGHAM, LA 71259
(318) 248-2797
(318) 248-3536
Mailing address
PO BOX 427, 714 BROADWAY, MANGHAM, LA 71259
(318) 248-2797
(318) 248-3536
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
377
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1402818
—
LA
Enumeration date
07/18/2006
Last updated
02/11/2009
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