CASANDRA KIMBERLAIN TUMBLIN B.A.

Adult Care Home

La Place, Louisiana

Provider NPI: 1922151091

Provider Information:
 CASANDRA KIMBERLAIN TUMBLIN B.A.


Practice Location:
1805 VIRGINIAN COLONY AVE  LA PLACE, LA 70068 US
Tel: 985-210-3358  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	3747P1801X	Nursing Service Related Providers Technician Personal Care Attendant
N	311ZA0620X	Nursing & Custodial Care Facilities Custodial Care Facility	LA	005181316

Other Provider Identifiers:

Issuer	Number	State	Type
	1922151091	LA	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin