Provider Demographics
NPI:1689887812
Name:CALCASIEU ASSOCIATION FOR RETARDED CITIZENS
Entity Type:Organization
Organization Name:CALCASIEU ASSOCIATION FOR RETARDED CITIZENS
Other - Org Name:CARC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:O
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:70615-3445
Mailing Address - Country:US
Mailing Address - Phone:337-433-3620
Mailing Address - Fax:337-439-1886
Practice Address - Street 1:1015 CHERRYHILL
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605
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:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA330315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1715816Medicaid