1124874524 NPI number — IKIGAI HEALTH SOLUTIONS LLC

Table of content: (NPI 1124874524)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124874524 NPI number — IKIGAI HEALTH SOLUTIONS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IKIGAI HEALTH SOLUTIONS LLC
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:
6
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:
1124874524
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
124 OAK COULEE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70507-4816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-315-7676
Provider Business Mailing Address Fax Number:
337-901-5822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4906 AMBASSADOR CAFFERY PKWY STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70508-6962
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-504-9707
Provider Business Practice Location Address Fax Number:
337-901-5822
Provider Enumeration Date:
04/25/2024

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON-LEDET
Authorized Official First Name:
MYISHA
Authorized Official Middle Name:
SANAE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
337-315-7676

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2550161 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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