Provider Demographics
NPI:1598817561
Name:CALCASIEU ASSOC FOR RETARDED CITIZENS, INC
Entity Type:Organization
Organization Name:CALCASIEU ASSOC FOR RETARDED CITIZENS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFLEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-433-3620
Mailing Address - Street 1:4100 J BENNETT JOHNSTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70615-5166
Mailing Address - Country:US
Mailing Address - Phone:337-433-3620
Mailing Address - Fax:337-439-1886
Practice Address - Street 1:4100 J BENNETT JOHNSTON AVE
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70615-5166
Practice Address - Country:US
Practice Address - Phone:337-433-3620
Practice Address - Fax:337-439-1886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2466385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1931551Medicaid