Provider Demographics
NPI:1942553813
Name:RELAX & ENJOY ADULT DAY CARE CENTER
Entity Type:Organization
Organization Name:RELAX & ENJOY ADULT DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ARIZA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:318-253-5868
Mailing Address - Street 1:P.O. BOX 1172
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-1172
Mailing Address - Country:US
Mailing Address - Phone:318-253-5868
Mailing Address - Fax:
Practice Address - Street 1:424 BENITA ST.
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351
Practice Address - Country:US
Practice Address - Phone:318-253-5868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA210090164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty