Provider Demographics
NPI:1720390727
Name:ALCEE, MARCUS AL (ADMIMISTRATOR)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:AL
Last Name:ALCEE
Suffix:
Gender:M
Credentials:ADMIMISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 MONTERREY DR SUITE B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814
Mailing Address - Country:US
Mailing Address - Phone:225-925-3412
Mailing Address - Fax:225-925-3413
Practice Address - Street 1:3009 MONTERREY DR
Practice Address - Street 2:STE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-4000
Practice Address - Country:US
Practice Address - Phone:225-925-3412
Practice Address - Fax:225-925-3413
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15396253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1356302Medicaid