Provider Demographics
NPI:1215379714
Name:ST MARY COMMUNITY ACTION AGENCY
Entity Type:Organization
Organization Name:ST MARY COMMUNITY ACTION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALMETRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-828-5703
Mailing Address - Street 1:1407 BARROW ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-3514
Mailing Address - Country:US
Mailing Address - Phone:337-828-5703
Mailing Address - Fax:337-828-5754
Practice Address - Street 1:1407 BARROW ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538-3514
Practice Address - Country:US
Practice Address - Phone:337-828-5703
Practice Address - Fax:337-828-5754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1929981Medicaid