Provider Demographics
NPI:1821364035
Name:TWIN CITY ADULT CARE SERVICES
Entity Type:Organization
Organization Name:TWIN CITY ADULT CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NEISES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:318-861-5696
Mailing Address - Street 1:559 DUDLEY DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-5023
Mailing Address - Country:US
Mailing Address - Phone:318-861-5696
Mailing Address - Fax:318-865-4182
Practice Address - Street 1:559 DUDLEY DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-5023
Practice Address - Country:US
Practice Address - Phone:318-861-5696
Practice Address - Fax:318-865-4182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00250653253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care