Provider Demographics
NPI:1710388343
Name:FAIR MAIDEN SERVICES
Entity Type:Organization
Organization Name:FAIR MAIDEN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CORRINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HERBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-206-1027
Mailing Address - Street 1:PO BOX 2131
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70054-2131
Mailing Address - Country:US
Mailing Address - Phone:504-206-1027
Mailing Address - Fax:
Practice Address - Street 1:601 VALLETTE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-1155
Practice Address - Country:US
Practice Address - Phone:504-206-1027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care