Provider Demographics
NPI: | 1639730583 |
---|---|
Name: | L & L SPECIALTY THERAPY |
Entity Type: | Organization |
Organization Name: | L & L SPECIALTY THERAPY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGING MEMBER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | MARCUS |
Authorized Official - Middle Name: | ANTOINE |
Authorized Official - Last Name: | LALONDE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 318-451-3989 |
Mailing Address - Street 1: | PO BOX 180 |
Mailing Address - Street 2: | |
Mailing Address - City: | BUNKIE |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 71322-0180 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 318-451-3989 |
Mailing Address - Fax: | 337-573-4307 |
Practice Address - Street 1: | 2834 MILITARY HWY |
Practice Address - Street 2: | |
Practice Address - City: | PINEVILLE |
Practice Address - State: | LA |
Practice Address - Zip Code: | 71360-4337 |
Practice Address - Country: | US |
Practice Address - Phone: | 318-346-7337 |
Practice Address - Fax: | 318-346-9269 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | MARCUS ANTOINE LALONDE |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2019-06-21 |
Last Update Date: | 2020-06-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |