Provider Demographics
NPI:1053500405
Name:LIVING STONES EMPLOYMENT SERVICES, LLC
Entity Type:Organization
Organization Name:LIVING STONES EMPLOYMENT SERVICES, LLC
Other - Org Name:LIVING STONES EMPLOYMENT SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:R
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-458-4368
Mailing Address - Street 1:5803 15TH ST S
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-2528
Mailing Address - Country:US
Mailing Address - Phone:504-458-4368
Mailing Address - Fax:205-565-0325
Practice Address - Street 1:2264 PLEASURE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-4568
Practice Address - Country:US
Practice Address - Phone:504-458-4368
Practice Address - Fax:205-565-0325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9437251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1146714Medicaid
LA1146790Medicaid
LA1171778Medicaid