Organization
GLOVE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE JAMES GOUDY JR. (ADMINISTRATOR)
(337) 363-4758
Entity
Organization
Contact information
Practice address
802 N. DUPRE ST.APT 34, VILLE PLATTE, LA 70586
(337) 363-4758
(337) 363-4758
Mailing address
PO BOX 2051, VILLE PLATTE, LA 70586-9051
(337) 363-4758
(337) 363-4760
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
386
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600723389
—
LA
Enumeration date
10/20/2015
Last updated
10/20/2015
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