Provider Demographics
NPI:1902091994
Name:SHARE CARE USA
Entity Type:Organization
Organization Name:SHARE CARE USA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONCRIEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-406-8228
Mailing Address - Street 1:PO BOX 51887
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1887
Mailing Address - Country:US
Mailing Address - Phone:337-406-8228
Mailing Address - Fax:337-406-8393
Practice Address - Street 1:106 LEONIE ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6228
Practice Address - Country:US
Practice Address - Phone:337-406-8228
Practice Address - Fax:337-406-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1304611251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1304611Medicaid