Organization
LOUISE'S PROMISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CAROL RAE SHINNETTE (EXECUTIVE DIRECTOR)
(205) 441-3106
Entity
Organization
Contact information
Practice address
4240 CAHABA DR, VESTAVIA, AL 35243-1600
(205) 441-3106
Mailing address
4240 CAHABA DR, VESTAVIA, AL 35243-1600
(205) 441-3106
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
15019719
AL
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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