Organization
AN ANGELS TOUCH OF THE RIVER REGION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH AVERY VICTOR (ADMINISTRATOR)
(985) 651-7887
Entity
Organization
Contact information
Practice address
121 MARIE STREET, LAPLACE, LA 70068
(985) 651-7887
(985) 651-5173
Mailing address
121 MARIE STREET, LAPLACE, LA 70068
(985) 651-7887
(985) 651-5173
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
10007
LA
385H00000X
Respite Care
9581
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1145181
—
LA
Enumeration date
08/09/2007
Last updated
08/09/2007
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