Provider Demographics
NPI:1376757047
Name:ROBINSWOOD SCHOOL FOR THE DEVELOPMENTALLY DISABLED
Entity Type:Organization
Organization Name:ROBINSWOOD SCHOOL FOR THE DEVELOPMENTALLY DISABLED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:PROPST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-436-6664
Mailing Address - Street 1:200 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70615-6816
Mailing Address - Country:US
Mailing Address - Phone:337-436-6664
Mailing Address - Fax:337-436-0250
Practice Address - Street 1:200 AVENUE C
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70615-6816
Practice Address - Country:US
Practice Address - Phone:337-436-6664
Practice Address - Fax:337-436-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19G010Medicaid