Provider Demographics
NPI:1619134640
Name:GALVEZ PERSONAL CARE SERVICE
Entity Type:Organization
Organization Name:GALVEZ PERSONAL CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERSEA
Authorized Official - Middle Name:P
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-338-9295
Mailing Address - Street 1:103 SAINT ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT ROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70087-3710
Mailing Address - Country:US
Mailing Address - Phone:504-338-9292
Mailing Address - Fax:
Practice Address - Street 1:103 SAINT ROSE AVE
Practice Address - Street 2:
Practice Address - City:SAINT ROSE
Practice Address - State:LA
Practice Address - Zip Code:70087-3710
Practice Address - Country:US
Practice Address - Phone:504-338-9292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA20063251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based