Provider Demographics
NPI:1316042369
Name:LOUISIANA CNI, LLC
Entity Type:Organization
Organization Name:LOUISIANA CNI, LLC
Other - Org Name:LOUISIANA CNI - BEAUREGARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-272-2090
Mailing Address - Street 1:12009 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-2702
Mailing Address - Country:US
Mailing Address - Phone:225-272-2090
Mailing Address - Fax:225-273-4305
Practice Address - Street 1:1877 GENERAL BEAUREGARD AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-6302
Practice Address - Country:US
Practice Address - Phone:225-769-8650
Practice Address - Fax:225-273-4305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA871315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1719501Medicaid