Provider Demographics
NPI:1922384312
Name:J. ALLEN INVESTMENT LLC
Entity Type:Organization
Organization Name:J. ALLEN INVESTMENT LLC
Other - Org Name:ALPHA GARDEN AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JA'JUAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-415-8872
Mailing Address - Street 1:42573 PLEASANT RIDGE ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-4764
Mailing Address - Country:US
Mailing Address - Phone:318-415-8872
Mailing Address - Fax:985-345-3060
Practice Address - Street 1:42573 PLEASANT RIDGE ROAD EXT
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-4764
Practice Address - Country:US
Practice Address - Phone:318-415-8872
Practice Address - Fax:985-345-3060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-29
Last Update Date:2011-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251T00000X, 252Y00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No252Y00000XAgenciesEarly Intervention Provider Agency