Provider Demographics
NPI:1225257090
Name:THE ARC OF MOREHOUSE
Entity Type:Organization
Organization Name:THE ARC OF MOREHOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LENARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:HALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-283-2338
Mailing Address - Street 1:10640 LUCY HUDSON DR
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-1838
Mailing Address - Country:US
Mailing Address - Phone:318-283-2338
Mailing Address - Fax:318-283-2340
Practice Address - Street 1:10640 LUCY HUDSON DR
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-1838
Practice Address - Country:US
Practice Address - Phone:318-283-2338
Practice Address - Fax:318-283-2340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2336251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1932337Medicaid