Provider Demographics
NPI:1982043287
Name:LIBERTY SIX COMMUNITY HOMES
Entity Type:Organization
Organization Name:LIBERTY SIX COMMUNITY HOMES
Other - Org Name:EUNICE DEVELOPMENTAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFLEUR JR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-546-0667
Mailing Address - Street 1:P.O. BOX 1287
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535
Mailing Address - Country:US
Mailing Address - Phone:337-546-0667
Mailing Address - Fax:337-546-6827
Practice Address - Street 1:1582 HWY 190 WEST
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535
Practice Address - Country:US
Practice Address - Phone:337-546-0667
Practice Address - Fax:337-546-6827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2528261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1093840597OtherNPI