Organization
ENTRUM CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE FULLER CMA, MA, MBA (ADMINISTRATOR)
(318) 949-1828
Entity
Organization
Contact information
Practice address
6235 HWY 157 S, HAUGHTON, LA 71037-7647
(318) 949-1828
(318) 949-1825
Mailing address
6235 HWY 157 S, HAUGHTON, LA 71037-7647
(318) 949-1828
(318) 949-1825
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
2134574
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2134574
—
LA
Enumeration date
04/05/2012
Last updated
04/05/2012
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