Organization
ABIDING IN THE VINE CARE PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY MARIE CHRISTOPHER (DIRECTOR)
(504) 267-0322
Entity
Organization
Contact information
Practice address
1141 WHITNEY AVE BLDG 2, GRETNA, LA 70056-5011
(504) 267-0322
(504) 265-0153
Mailing address
1141 WHITNEY AVE BLDG 2, GRETNA, LA 70056-5011
(504) 267-0322
(504) 265-0153
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
04/18/2018
Last updated
08/23/2019
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