Provider Demographics
NPI:1003980632
Name:POINTE COUPEE COMMUNITY CARE
Entity type:Organization
Organization Name:POINTE COUPEE COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUGEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-473-0863
Mailing Address - Street 1:3700 BAYOU RAPIDES RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3601
Mailing Address - Country:US
Mailing Address - Phone:318-473-0863
Mailing Address - Fax:318-473-9889
Practice Address - Street 1:148B E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-3506
Practice Address - Country:US
Practice Address - Phone:225-618-0202
Practice Address - Fax:225-618-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1149527Medicaid