Provider Demographics
NPI:1780850156
Name:CARE AND DEVELOPMENT CENTER INC
Entity Type:Organization
Organization Name:CARE AND DEVELOPMENT CENTER INC
Other - Org Name:SAME AS ABOVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:504-833-8383
Mailing Address - Street 1:827 CAUSEWAY BLVD
Mailing Address - Street 2:827 SOUTH CAUSEWAY
Mailing Address - City:JEFFERSON
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2738
Mailing Address - Country:US
Mailing Address - Phone:504-833-8383
Mailing Address - Fax:504-833-0983
Practice Address - Street 1:827 CAUSEWAY BLVD
Practice Address - Street 2:827 SOUTH CAUSEWAY
Practice Address - City:JEFFERSON
Practice Address - State:LA
Practice Address - Zip Code:70121-2738
Practice Address - Country:US
Practice Address - Phone:504-833-8383
Practice Address - Fax:504-833-0983
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAME AS ABOVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1460044302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1460044Medicaid