Organization
PORT CITY ENTERPRISES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE C. DUNLEVY (EXECUTIVE DIRECTOR)
(225) 344-1142
Entity
Organization
Contact information
Practice address
836 N 7TH ST, PORT ALLEN, LA 70767
(225) 344-1142
(225) 344-1192
Mailing address
836 NORTH 7TH ST, PORT ALLEN, LA 70767
(225) 344-1142
(225) 344-1192
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
ADC 2263
LA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
PCA 4624
LA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
RC 6081
LA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
SIL 4589
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1551988
—
LA
05
—
1686638
—
LA
05
—
1686646
—
LA
05
—
1911283
—
LA
05
—
1937746
—
LA
Enumeration date
04/27/2007
Last updated
08/22/2020
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