Provider Demographics
NPI:1568831246
Name:LAURA LEA ENTERPRISES LLC
Entity Type:Organization
Organization Name:LAURA LEA ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-485-0725
Mailing Address - Street 1:5053 ANNETTE ST.
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805
Mailing Address - Country:US
Mailing Address - Phone:225-485-0725
Mailing Address - Fax:
Practice Address - Street 1:5053 ANNETTE ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-3702
Practice Address - Country:US
Practice Address - Phone:225-485-0725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health