Provider Demographics
NPI:1780785865
Name:PROFESSIONAL HEALTHCARE ENTERPRISES LLC
Entity type:Organization
Organization Name:PROFESSIONAL HEALTHCARE ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATRESHA
Authorized Official - Middle Name:G
Authorized Official - Last Name:ONEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-951-1181
Mailing Address - Street 1:PO BOX 1515
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71294-1515
Mailing Address - Country:US
Mailing Address - Phone:706-951-1181
Mailing Address - Fax:
Practice Address - Street 1:2106 N 7TH ST
Practice Address - Street 2:SUITE 125
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-4445
Practice Address - Country:US
Practice Address - Phone:706-951-1181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251J00000XAgenciesNursing Care
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment