JARVIS DECARLEONNE LARRY

SHREVEPORT, LA
NPI1750875944
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies172V00000X Community Health Worker
Enumeration Date2018-06-20
Last Update Date2018-06-27
Business Address
Mr. JARVIS DECARLEONNE LARRY
1513 LINE AVE # 222
SHREVEPORT, LA 71101
Phone number: 318-208-8908
Mailing Address
Mr. JARVIS DECARLEONNE LARRY
1172 PELICAN CREEK DR
SHREVEPORT, LA 71106-8539
Phone number: 318-617-8767