Provider Demographics
NPI:1659409589
Name:ASSUMPTION ASSOCIATION FOR RETARDED CITIZENS, INC.
Entity Type:Organization
Organization Name:ASSUMPTION ASSOCIATION FOR RETARDED CITIZENS, INC.
Other - Org Name:NAPOLEONVILLE MANOR
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:H
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-369-2908
Mailing Address - Street 1:PO BOX 1040
Mailing Address - Street 2:
Mailing Address - City:NAPOLEONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70390-1040
Mailing Address - Country:US
Mailing Address - Phone:985-369-2908
Mailing Address - Fax:985-369-2657
Practice Address - Street 1:4201 HWY 1
Practice Address - Street 2:
Practice Address - City:NAPOLEONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70390
Practice Address - Country:US
Practice Address - Phone:985-369-2908
Practice Address - Fax:985-369-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA453310500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1716898Medicaid