Provider Demographics
NPI:1336550342
Name:RELIABLE PCA AGENCY LLC
Entity Type:Organization
Organization Name:RELIABLE PCA AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:QUENTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-340-5306
Mailing Address - Street 1:75 DOMINICAN RD STE 209
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-3400
Mailing Address - Country:US
Mailing Address - Phone:504-340-5306
Mailing Address - Fax:504-328-7677
Practice Address - Street 1:75 DOMINICAN RD STE 209
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3400
Practice Address - Country:US
Practice Address - Phone:504-340-5306
Practice Address - Fax:504-328-7677
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RELIABLE PCA AGENCY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based