Provider Demographics
NPI:1912377425
Name:LOUISE'S PROMISE LLC
Entity Type:Organization
Organization Name:LOUISE'S PROMISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SHINNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-441-3106
Mailing Address - Street 1:4240 CAHABA DR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-1600
Mailing Address - Country:US
Mailing Address - Phone:205-441-3106
Mailing Address - Fax:
Practice Address - Street 1:4240 CAHABA DR
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-1600
Practice Address - Country:US
Practice Address - Phone:205-441-3106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15019719251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization