Organization Name: | E D&J GROUP HOME |
NPI Number: | 1316077993 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BYKEN GENEVA JOHNSON (OFFICE MANAGER) |
Mailing Address: | 5000 St Claude Ave New Orleans |
State: | LA US |
Postal Code: | 70117 |
Phone Number: | 5042720269 |
Fax Number: | 5042720269 |
NPI Enumeration Date: | 03/06/2007 |
NPI Last Update Date: | 09/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | PCA 12018 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |