Provider Demographics
NPI:1609033943
Name:RESOURCES FOR INDEPENDENT LIVING, INC.
Entity Type:Organization
Organization Name:RESOURCES FOR INDEPENDENT LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YAVONKA
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARCHAGA
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:504-522-1955
Mailing Address - Street 1:11931 INDUSTRIPLEX BLVD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-5140
Mailing Address - Country:US
Mailing Address - Phone:225-753-4772
Mailing Address - Fax:225-753-4831
Practice Address - Street 1:11931 INDUSTRIPLEX BLVD
Practice Address - Street 2:SUITE #200
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-5140
Practice Address - Country:US
Practice Address - Phone:225-753-4772
Practice Address - Fax:225-753-4831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA112203747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1468801Medicaid