Provider Demographics
NPI:1093061699
Name:ACP VOCATIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:ACP VOCATIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-925-5003
Mailing Address - Street 1:830 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-3442
Mailing Address - Country:US
Mailing Address - Phone:225-389-6224
Mailing Address - Fax:
Practice Address - Street 1:830 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-3442
Practice Address - Country:US
Practice Address - Phone:225-389-6224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1808989Medicaid