Organization
MALICORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ALICE FUSELIER (C.E.O.)
(337) 993-2005
Entity
Organization
Contact information
Practice address
100 TOULOUSE DR, LAFAYETTE, LA 70506-5132
(337) 993-2005
(337) 993-2026
Mailing address
100 TOULOUSE DR, LAFAYETTE, LA 70506-5132
(337) 993-2005
(337) 993-2026
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
4504110
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437697
—
LA
Enumeration date
03/09/2007
Last updated
08/22/2020
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