Organization
HELPING THE SICK N SHUT IN OF NOTH LA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LAKEISHIA KAWON JOHNSON L.V.N (HOME HEALTH)
(318) 946-2487
Entity
Organization
Contact information
Practice address
5342 BROADWAY AVE, SHREVEPORT, LA 71109-7210
(318) 946-2487
Mailing address
5342 BROADWAY AVE, SHREVEPORT, LA 71109
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
3747P180X
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144673963
RED# 212185120518
LA
01
—
1604091000
MEDICAL ASSISTANT ON THE JOB TRAINING
LA
Enumeration date
04/06/2017
Last updated
04/06/2017
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