Provider Demographics
NPI:1275747917
Name:CHRISTIANFOUNDATIONINC
Entity Type:Organization
Organization Name:CHRISTIANFOUNDATIONINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WARR
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:1225-474-5475
Mailing Address - Street 1:266 MYRTLE GROVE ST
Mailing Address - Street 2:
Mailing Address - City:DONALDSONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70346-4340
Mailing Address - Country:US
Mailing Address - Phone:225-474-5475
Mailing Address - Fax:225-474-5485
Practice Address - Street 1:266 MYRTLE GROVE STREET
Practice Address - Street 2:
Practice Address - City:DONALDSONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70346-4340
Practice Address - Country:US
Practice Address - Phone:225-474-5475
Practice Address - Fax:225-474-5485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10679247000000X, 247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationGroup - Multi-Specialty
Not Answered247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1196126Medicaid