Provider Demographics
NPI:1225231475
Name:LIGHTHOUSE FOR THE BLIND IN NEW ORLEANS
Entity Type:Organization
Organization Name:LIGHTHOUSE FOR THE BLIND IN NEW ORLEANS
Other - Org Name:LIGHTHOUSE LOUISIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUDGEWATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-899-4501
Mailing Address - Street 1:123 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5733
Mailing Address - Country:US
Mailing Address - Phone:504-899-4501
Mailing Address - Fax:504-899-4529
Practice Address - Street 1:123 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5733
Practice Address - Country:US
Practice Address - Phone:504-899-4501
Practice Address - Fax:504-899-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1341606Medicaid
LA5DK79OtherPTAN