Provider Demographics
NPI:1457577892
Name:SPECIAL NEEDS UNLIMITED, L.L.C.
Entity Type:Organization
Organization Name:SPECIAL NEEDS UNLIMITED, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:T
Authorized Official - Last Name:BRANDON
Authorized Official - Suffix:
Authorized Official - Credentials:BS W
Authorized Official - Phone:225-925-5003
Mailing Address - Street 1:2320 DRUSILLA LN
Mailing Address - Street 2:SUITE D
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1495
Mailing Address - Country:US
Mailing Address - Phone:225-925-5003
Mailing Address - Fax:225-248-1063
Practice Address - Street 1:2320 DRUSILLA LN
Practice Address - Street 2:SUITE D
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1495
Practice Address - Country:US
Practice Address - Phone:225-925-5003
Practice Address - Fax:225-248-1063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11299261QD1600X
LA11297261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1470732Medicaid
LA1471321Medicaid
LA1125482Medicaid