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Organization

LIFETIME PCS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SANDRA THRASH (ADMINISTRATOR)
(504) 962-3101
Entity
Organization

Contact information

Practice address
1010 COMMON ST, SUITE 2660, NEW ORLEANS, LA 70112-2401
(504) 962-3101
(504) 962-3102
Mailing address
1010 COMMON ST, SUITE 2660, NEW ORLEANS, LA 70112-2401
(504) 962-3101
(504) 962-3102

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
PCA 11694
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447200753
LA
05
1669505798
LA
05
1811200595
LA
Enumeration date
10/19/2011
Last updated
10/19/2011
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