Provider Demographics
NPI:1942475108
Name:BUMGARNER CLIENT CARE SERVICES INC
Entity Type:Organization
Organization Name:BUMGARNER CLIENT CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUMGARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-322-7477
Mailing Address - Street 1:4640 S CARROLLTON AVE
Mailing Address - Street 2:STE. 200A-7
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6051
Mailing Address - Country:US
Mailing Address - Phone:504-322-7477
Mailing Address - Fax:504-322-7520
Practice Address - Street 1:4640 S CARROLLTON AVE
Practice Address - Street 2:STE. 200A-7
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6051
Practice Address - Country:US
Practice Address - Phone:504-322-7477
Practice Address - Fax:504-322-7520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14036251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services