Provider Demographics
NPI:1710112578
Name:SLS INC
Entity Type:Organization
Organization Name:SLS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-810-9622
Mailing Address - Street 1:PO BOX 67280
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70896-7280
Mailing Address - Country:US
Mailing Address - Phone:225-810-9622
Mailing Address - Fax:225-927-9456
Practice Address - Street 1:921 N LOBDELL AVE
Practice Address - Street 2:SUITE F
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-8811
Practice Address - Country:US
Practice Address - Phone:225-810-9622
Practice Address - Fax:225-927-9456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10557251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1475220Medicaid