Provider Demographics
NPI:1427592310
Name:JACKIE'S LOVIN TOUCH PROFESSIONAL CARE SERVICES
Entity Type:Organization
Organization Name:JACKIE'S LOVIN TOUCH PROFESSIONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIETISCHA
Authorized Official - Middle Name:JACQUENETTE
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-228-9571
Mailing Address - Street 1:316 FEDERAL DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:LA
Mailing Address - Zip Code:70094-2433
Mailing Address - Country:US
Mailing Address - Phone:504-228-9571
Mailing Address - Fax:
Practice Address - Street 1:316 FEDERAL DR
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:LA
Practice Address - Zip Code:70094-2433
Practice Address - Country:US
Practice Address - Phone:504-228-9571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities