1417252230 NPI number — VOLUNTEERS OF AMERICA OF NORTH LOUISIANA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417252230 NPI number — VOLUNTEERS OF AMERICA OF NORTH LOUISIANA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VOLUNTEERS OF AMERICA OF NORTH LOUISIANA
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:
Provider Other Organization Name Type Code:
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:
1417252230
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
360 JORDAN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHREVEPORT
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-221-2669
Provider Business Mailing Address Fax Number:
318-429-7502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
458 HERNDON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71101-4859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-429-6938
Provider Business Practice Location Address Fax Number:
318-629-2870
Provider Enumeration Date:
01/26/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BLACK
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
318-429-6948

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2137719 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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