Provider Demographics
NPI:1851632699
Name:ST. NICHOLAS CENTER FOR CHILDREN
Entity Type:Organization
Organization Name:ST. NICHOLAS CENTER FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPINIA-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-491-0800
Mailing Address - Street 1:314 BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-4224
Mailing Address - Country:US
Mailing Address - Phone:337-491-0800
Mailing Address - Fax:
Practice Address - Street 1:314 BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-4224
Practice Address - Country:US
Practice Address - Phone:337-491-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1-13-13330261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities