Provider Demographics
NPI:1164640314
Name:A AND L OF NORTHEAST INC
Entity Type:Organization
Organization Name:A AND L OF NORTHEAST INC
Other - Org Name:ANGELSHEALTHCARE SITTER SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-325-5221
Mailing Address - Street 1:PO BOX 9425
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71211-9425
Mailing Address - Country:US
Mailing Address - Phone:318-336-1251
Mailing Address - Fax:
Practice Address - Street 1:1705 CARTER ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3112
Practice Address - Country:US
Practice Address - Phone:318-336-1251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10409251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1168165Medicaid