Provider Demographics
NPI:1063657930
Name:TOTAL ASSURANCE INC.
Entity Type:Organization
Organization Name:TOTAL ASSURANCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:DARNELL
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:SR
Authorized Official - Credentials:MBA, HCM
Authorized Official - Phone:337-896-9923
Mailing Address - Street 1:505 LOIRE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-2455
Mailing Address - Country:US
Mailing Address - Phone:337-896-9923
Mailing Address - Fax:337-896-9685
Practice Address - Street 1:505 LOIRE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2455
Practice Address - Country:US
Practice Address - Phone:337-896-9923
Practice Address - Fax:337-896-9685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14019251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1332755Medicaid