Provider Demographics
NPI:1740741388
Name:MARY LEES HOUSE OF LOVE ADULT DAY HEALTHCARE
Entity Type:Organization
Organization Name:MARY LEES HOUSE OF LOVE ADULT DAY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EUGENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-623-4411
Mailing Address - Street 1:403 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71353
Mailing Address - Country:US
Mailing Address - Phone:337-623-4411
Mailing Address - Fax:
Practice Address - Street 1:403 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:LA
Practice Address - Zip Code:71353
Practice Address - Country:US
Practice Address - Phone:337-623-4411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-27
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care