Provider Demographics
NPI:1417019159
Name:SPECIAL EDUCATION DISTRICT 1 OF LAFOURCHE
Entity Type:Organization
Organization Name:SPECIAL EDUCATION DISTRICT 1 OF LAFOURCHE
Other - Org Name:THE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-632-5671
Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345-0405
Mailing Address - Country:US
Mailing Address - Phone:985-632-5671
Mailing Address - Fax:985-632-5659
Practice Address - Street 1:5510 WEST AVE D
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345
Practice Address - Country:US
Practice Address - Phone:985-632-5671
Practice Address - Fax:985-632-5659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LASIL 11972 LA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1627763Medicaid