Provider Demographics
NPI:1861679466
Name:BERRY'S RELIABLE RESOURCES L.L.C.
Entity Type:Organization
Organization Name:BERRY'S RELIABLE RESOURCES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:504-272-0795
Mailing Address - Street 1:4664 JAMESTOWN AVE
Mailing Address - Street 2:STE.135
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3241
Mailing Address - Country:US
Mailing Address - Phone:225-231-7117
Mailing Address - Fax:504-304-9242
Practice Address - Street 1:4664 JAMESTOWN AVE
Practice Address - Street 2:STE 135
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3241
Practice Address - Country:US
Practice Address - Phone:225-231-7117
Practice Address - Fax:504-304-9242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14060251G00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1028231Medicaid