1134283989 NPI number — SPECIAL EDUCATION DISTRICT 1 OF LAFOURCHE

Table of content: (NPI 1134283989)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134283989 NPI number — SPECIAL EDUCATION DISTRICT 1 OF LAFOURCHE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPECIAL EDUCATION DISTRICT 1 OF LAFOURCHE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE CENTER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134283989
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 405
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUT OFF
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70345-0405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-632-5671
Provider Business Mailing Address Fax Number:
985-632-5659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5510 WEST AVENUE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUT OFF
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-632-5671
Provider Business Practice Location Address Fax Number:
985-632-5659
Provider Enumeration Date:
12/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
LESTER
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
985-632-5671

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , with the licence number:  PCA 11965 LA , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1627721 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".