Organization
IMMACULATE HEART OF MARY-PCS, LLC
Active
Organization
IMMACULATE HEART OF MARY-PCS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENNETT MORIAN (OWNER)
(337) 623-4109
Entity
Organization
Contact information
Practice address
226 LYONS ST., MELVILLE, LA 71353-0670
(337) 623-4100
(337) 623-4102
Mailing address
PO BOX 670, MELVILLE, LA 71353-0670
(337) 623-4109
(337) 623-4102
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
12145
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1621676
—
LA
Enumeration date
04/06/2007
Last updated
06/17/2008
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