Provider Demographics
NPI:1588830319
Name:SEASONS CARE SERVICES
Entity Type:Organization
Organization Name:SEASONS CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:225-927-8687
Mailing Address - Street 1:311 E AIRPORT AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-4840
Mailing Address - Country:US
Mailing Address - Phone:225-927-8687
Mailing Address - Fax:225-927-3366
Practice Address - Street 1:311 E AIRPORT AVE
Practice Address - Street 2:SUITE E
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4840
Practice Address - Country:US
Practice Address - Phone:225-927-8687
Practice Address - Fax:225-927-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14088251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1509523Medicaid