Provider Demographics
NPI:1417325648
Name:DAIGRES OF LA INC
Entity Type:Organization
Organization Name:DAIGRES OF LA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COE
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:DAIGRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-610-4757
Mailing Address - Street 1:934 W ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-8553
Mailing Address - Country:US
Mailing Address - Phone:225-610-4757
Mailing Address - Fax:225-388-0905
Practice Address - Street 1:934 W ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-8553
Practice Address - Country:US
Practice Address - Phone:225-610-4757
Practice Address - Fax:225-388-0905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA006354075343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)