Organization · NPI-2
1st A Southeast Incs, LLC
Point of Service · Houma, LA
NPI number1295952190
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1295952190
- Entity type
- Organization (NPI-2)
- Legal business name
- 1st A Southeast Incs, LLC
- Organization subpart
- No
- Enumeration date
- Apr 20, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305S00000X | Point of Service | 12649 | LA | Yes |
Practice location
614 Roussell StHouma, LA 70360-4556
Phone 985-876-0559
Mailing address
614 Roussell StHouma, LA 70360-4556
Phone 985-876-0559
Authorized official
Suzanne Dickerson
Program Coordinator
9858760559
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