Provider Demographics
NPI:1063802379
Name:CHEZ ELMA ADULT DAY HEALTH CARE CENTER INC
Entity type:Organization
Organization Name:CHEZ ELMA ADULT DAY HEALTH CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:JESSICA
Authorized Official - Last Name:MONTGOMERY-COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-265-4366
Mailing Address - Street 1:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:VACHERIE
Mailing Address - State:LA
Mailing Address - Zip Code:70090-0106
Mailing Address - Country:US
Mailing Address - Phone:225-265-4366
Mailing Address - Fax:225-265-2263
Practice Address - Street 1:154 N HOLLYWOOD RD STE C
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364-2806
Practice Address - Country:US
Practice Address - Phone:985-601-3157
Practice Address - Fax:985-746-4163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203782219261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========Medicaid