Provider Demographics
NPI:1174973747
Name:ANOTHER LEVEL LLC
Entity type:Organization
Organization Name:ANOTHER LEVEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:DAVILLIER
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-614-8945
Mailing Address - Street 1:101 CURRY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:LA
Mailing Address - Zip Code:71225-7947
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 CURRY CREEK CT
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:LA
Practice Address - Zip Code:71225-7947
Practice Address - Country:US
Practice Address - Phone:318-614-8945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service