Provider Demographics
NPI:1811190333
Name:ST JAMES ARC
Entity Type:Organization
Organization Name:ST JAMES ARC
Other - Org Name:VACHERIE DAY DEVELOPMENTAL TRAINING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-265-7910
Mailing Address - Street 1:29150 HEALTH UNIT ST
Mailing Address - Street 2:
Mailing Address - City:VACHERIE
Mailing Address - State:LA
Mailing Address - Zip Code:70090-4221
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:225-265-3278
Practice Address - Street 1:29150 HEALTH UNIT ST
Practice Address - Street 2:
Practice Address - City:VACHERIE
Practice Address - State:LA
Practice Address - Zip Code:70090-4221
Practice Address - Country:US
Practice Address - Phone:225-265-7910
Practice Address - Fax:225-265-3278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2264251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1439550Medicaid