Provider Demographics
NPI:1063792455
Name:SALUBRIOUS HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:SALUBRIOUS HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZAUNBRECHER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:337-384-1334
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:ESTHERWOOD
Mailing Address - State:LA
Mailing Address - Zip Code:70534-0391
Mailing Address - Country:US
Mailing Address - Phone:337-384-1334
Mailing Address - Fax:337-334-7556
Practice Address - Street 1:717 CURTIS DR
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-8311
Practice Address - Country:US
Practice Address - Phone:337-384-1334
Practice Address - Fax:337-334-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP03174363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty