Organization
BAYOU ADVANTAGE, LLC
Active
Organization
BAYOU ADVANTAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNA BROADWAY (OWNER/MANAGER/OPERATOR)
(225) 323-4394
Entity
Organization
Contact information
Practice address
13313 JACKSON RD, ZACHARY, LA 70791-7638
(225) 323-4394
Mailing address
PO BOX 158, PRIDE, LA 70770-0158
(225) 323-4394
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
05/30/2014
Last updated
10/08/2014
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