1891977369 NPI number — TRUE CARE LLC

Table of content: (NPI 1891977369)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891977369 NPI number — TRUE CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRUE CARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TRUE CARE HEALTH & WELLNESS CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891977369
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/05/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20959 ANDERSON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ZACHARY
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70791-7915
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-367-8174
Provider Business Mailing Address Fax Number:
225-658-5487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20959 ANDERSON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ZACHARY
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70791-7915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-588-3209
Provider Business Practice Location Address Fax Number:
225-658-5487
Provider Enumeration Date:
11/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
EVANS
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
SNOWDEN
Authorized Official Title or Position:
FAMILY NURSE PRACTITIONER
Authorized Official Telephone Number:
225-367-8174

Provider Taxonomy Codes

  • Taxonomy code: 364SF0001X , with the licence number:  AP082678 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1000400 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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