Provider Demographics
NPI:1356438212
Name:ANIOMA LIVING INC
Entity type:Organization
Organization Name:ANIOMA LIVING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAIGE DENE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OKPALOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-874-3748
Mailing Address - Street 1:1799 STUMPF BLVD BLD 7 SUITE 8
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056
Mailing Address - Country:US
Mailing Address - Phone:504-368-9191
Mailing Address - Fax:504-368-9192
Practice Address - Street 1:1241 ELYSIAN FIELDS
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119
Practice Address - Country:US
Practice Address - Phone:504-947-3838
Practice Address - Fax:504-368-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
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
LA1717614Medicaid