Provider Demographics
NPI:1568492841
Name:LAFAYETTE HEALTH VENTURES, INC
Entity Type:Organization
Organization Name:LAFAYETTE HEALTH VENTURES, INC
Other - Org Name:NEUROLOGY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-289-8972
Mailing Address - Street 1:1211 COOLIDGE BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2636
Mailing Address - Country:US
Mailing Address - Phone:337-289-8414
Mailing Address - Fax:337-289-8970
Practice Address - Street 1:1211 COOLIDGE BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2636
Practice Address - Country:US
Practice Address - Phone:337-289-8414
Practice Address - Fax:337-289-8970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1706451Medicaid
LACG2600OtherRAILROAD MEDICARE
LACG2600OtherRAILROAD MEDICARE