Provider Demographics
NPI:1326327875
Name:WRAP AROUND SERVICES OF RACELAND LLC
Entity Type:Organization
Organization Name:WRAP AROUND SERVICES OF RACELAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE/CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EARNEST
Authorized Official - Middle Name:ELEGBONOSA
Authorized Official - Last Name:AIRHIA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:985-537-6776
Mailing Address - Street 1:4079 HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:RACELAND
Mailing Address - State:LA
Mailing Address - Zip Code:70394-3002
Mailing Address - Country:US
Mailing Address - Phone:985-537-6776
Mailing Address - Fax:985-537-6779
Practice Address - Street 1:4079 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:LA
Practice Address - Zip Code:70394-3002
Practice Address - Country:US
Practice Address - Phone:985-537-6776
Practice Address - Fax:985-537-6779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health