Provider Demographics
NPI:1467324517
Name:DFAC3 LLC
Entity type:Organization
Organization Name:DFAC3 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LASHONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-209-1906
Mailing Address - Street 1:1500 LAFAYETTE ST STE 123
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-5732
Mailing Address - Country:US
Mailing Address - Phone:504-688-1019
Mailing Address - Fax:
Practice Address - Street 1:1500 LAFAYETTE ST STE 123
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-5732
Practice Address - Country:US
Practice Address - Phone:504-688-1019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization