Provider Demographics
NPI:1770146987
Name:NORTH TANGI ADULT DAY CARE
Entity type:Organization
Organization Name:NORTH TANGI ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:985-507-2573
Mailing Address - Street 1:45246 MORRIS RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-7816
Mailing Address - Country:US
Mailing Address - Phone:985-507-2573
Mailing Address - Fax:985-247-2509
Practice Address - Street 1:1005 NW CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-5723
Practice Address - Country:US
Practice Address - Phone:985-247-2509
Practice Address - Fax:985-247-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care