Provider Demographics
NPI:1871806794
Name:AMAZING CARE SERVICES
Entity type:Organization
Organization Name:AMAZING CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-822-8361
Mailing Address - Street 1:3308 TULANE AVE
Mailing Address - Street 2:412
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7100
Mailing Address - Country:US
Mailing Address - Phone:504-822-8361
Mailing Address - Fax:504-827-5421
Practice Address - Street 1:3308 TULANE AVE
Practice Address - Street 2:412
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7100
Practice Address - Country:US
Practice Address - Phone:504-822-8361
Practice Address - Fax:504-827-5421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LASIL 7326253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1457534059Medicaid
LA1629273826Medicaid