Provider Demographics
NPI:1043424757
Name:COMMUNITY LIVING ALTERNATIVES, INC.
Entity Type:Organization
Organization Name:COMMUNITY LIVING ALTERNATIVES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-471-0086
Mailing Address - Street 1:2200 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062-4001
Mailing Address - Country:US
Mailing Address - Phone:504-471-0086
Mailing Address - Fax:504-471-0664
Practice Address - Street 1:2200 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-4001
Practice Address - Country:US
Practice Address - Phone:504-471-0086
Practice Address - Fax:504-471-0664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9286251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1740951Medicaid