Organization
GOOD SHEPHERD PERSONAL CARE SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY HARRIS III (OWNER)
(318) 283-0220
Entity
Organization
Contact information
Practice address
206 W MADISON AVE, BASTROP, LA 71220-3756
(318) 283-0220
(318) 283-0210
Mailing address
206 W MADISON AVE, BASTROP, LA 71220-3756
(318) 283-0220
(318) 283-0210
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
6958
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1706892
—
LA
Enumeration date
05/03/2007
Last updated
06/18/2008
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