Provider Demographics
NPI:1093834277
Name:EASTER SEALS LOUISIANA
Entity Type:Organization
Organization Name:EASTER SEALS LOUISIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-523-7325
Mailing Address - Street 1:1010 COMMON ST
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 WASHINGTON ST
Practice Address - Street 2:SUITE 212
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6714
Practice Address - Country:US
Practice Address - Phone:318-805-0454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management