Provider Demographics
NPI:1033441126
Name:SAINT NICHOLAS CENTER FOR EARLY INTERVENTION
Entity Type:Organization
Organization Name:SAINT NICHOLAS CENTER FOR EARLY INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DYNETTE
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOFFPAUIR
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:337-491-0800
Mailing Address - Street 1:314 BROAD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-4224
Mailing Address - Country:US
Mailing Address - Phone:337-491-0800
Mailing Address - Fax:337-491-0508
Practice Address - Street 1:314 BROAD ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-4224
Practice Address - Country:US
Practice Address - Phone:337-491-0800
Practice Address - Fax:337-491-0508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty