Provider Demographics
NPI:1609517473
Name:PERSONAL TOUCH CENTER BASED RESPITE AND ADULT DAY CARE
Entity Type:Organization
Organization Name:PERSONAL TOUCH CENTER BASED RESPITE AND ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-667-4999
Mailing Address - Street 1:PO BOX 87116
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70879-8116
Mailing Address - Country:US
Mailing Address - Phone:225-667-4999
Mailing Address - Fax:225-667-4998
Practice Address - Street 1:1950 FLORIDA AVE SW
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4911
Practice Address - Country:US
Practice Address - Phone:225-380-5206
Practice Address - Fax:225-380-5207
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERSONAL TOUCH HEALTHCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1Medicaid