Provider Demographics
NPI:1568614311
Name:WINN ASSOCIATION FOR RETARDED CITIZENS
Entity Type:Organization
Organization Name:WINN ASSOCIATION FOR RETARDED CITIZENS
Other - Org Name:WINN SHELTERED WORKSHOP
Other - Org Type:Other Name
Authorized Official - Title/Position:STAND IN CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-628-7654
Mailing Address - Street 1:1006 S. JONES ST.
Mailing Address - Street 2:PO BOX 566
Mailing Address - City:WINNFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71483
Mailing Address - Country:US
Mailing Address - Phone:318-628-7654
Mailing Address - Fax:318-648-2665
Practice Address - Street 1:1006 SOUTH JONES ST.
Practice Address - Street 2:
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483
Practice Address - Country:US
Practice Address - Phone:318-628-7654
Practice Address - Fax:318-648-2665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAADC 5271251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1936430Medicaid