Provider Demographics
NPI:1598953036
Name:ACCESS HEALTH LOUISIANA
Entity Type:Organization
Organization Name:ACCESS HEALTH LOUISIANA
Other - Org Name:NORCO ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TRENTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-575-3700
Mailing Address - Street 1:843 MILLING AVE
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-4442
Mailing Address - Country:US
Mailing Address - Phone:504-575-3712
Mailing Address - Fax:504-575-3691
Practice Address - Street 1:16004 RIVER RD
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:LA
Practice Address - Zip Code:70079-2040
Practice Address - Country:US
Practice Address - Phone:985-764-9084
Practice Address - Fax:504-575-3691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAADHC1975385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1971383Medicaid
LA1444642Medicaid