Organization Name: | PORT CITY ENTERPRISES, INC. |
NPI Number: | 1881814150 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTINE C. DUNLEVY (EXECUTIVE DIRECTOR) |
Mailing Address: | 836 N 7th St Port Allen |
State: | LA US |
Postal Code: | 70767 |
Phone Number: | 2253441142 |
Fax Number: | 2253441192 |
NPI Enumeration Date: | 04/27/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385HR2060X |
License Number: | PCA 4624 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Taxonomy Definition: | A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers. |