Basic Information
| Provider Information | |||||||||
| NPI: | 1457023103 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GUIDANCE PERSONAL CARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1204 STUBBS AVENUE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 71201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3185825633 | ||||||||
| FaxNumber: | 3185825646 | ||||||||
| Practice Location | |||||||||
| Address1: | 1204 STUBBS AVENUE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 71201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3185825633 | ||||||||
| FaxNumber: | 3185825646 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2021 | ||||||||
| LastUpdateDate: | 10/01/2021 | ||||||||
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| AuthorizedOfficialLastName: | FREEMAN | ||||||||
| AuthorizedOfficialFirstName: | TONIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 3185825633 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | N | Agencies | Home Health | 320900000X | Y | Residential Treatment Facilities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
No ID Information.