Provider Demographics
NPI:1437378908
Name:LOUISIANA SPECIAL EDUCATION CENTER
Entity Type:Organization
Organization Name:LOUISIANA SPECIAL EDUCATION CENTER
Other - Org Name:TRANSITIONAL FAMILY LIFE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:NFA
Authorized Official - Phone:318-487-5494
Mailing Address - Street 1:100 PECAN LOOP
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3753
Mailing Address - Country:US
Mailing Address - Phone:318-487-5004
Mailing Address - Fax:318-487-5768
Practice Address - Street 1:100 PECAN LOOP
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3753
Practice Address - Country:US
Practice Address - Phone:318-487-5004
Practice Address - Fax:318-487-5768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1712345313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1712345Medicare ID - Type UnspecifiedPROVIDER NUMBER