Provider Demographics
NPI:1790926921
Name:JESSIE'S TOUCH PCA SERVICES, LLC
Entity Type:Organization
Organization Name:JESSIE'S TOUCH PCA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CORTNEA
Authorized Official - Middle Name:TROYLYNN
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-278-4555
Mailing Address - Street 1:1519 E JUDGE PEREZ DR STE 2
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-5569
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1519 E JUDGE PEREZ DR STE 2
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-5569
Practice Address - Country:US
Practice Address - Phone:504-278-4555
Practice Address - Fax:504-278-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services