Provider Demographics
NPI: | 1457590598 |
---|---|
Name: | EMPOWERING HEALTHCARE TOO ADULT DAY PROGRAM |
Entity Type: | Organization |
Organization Name: | EMPOWERING HEALTHCARE TOO ADULT DAY PROGRAM |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | CHANDA |
Authorized Official - Middle Name: | HALL |
Authorized Official - Last Name: | TURNER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RSW |
Authorized Official - Phone: | 225-328-9200 |
Mailing Address - Street 1: | 22852 PLANK RD |
Mailing Address - Street 2: | |
Mailing Address - City: | ZACHARY |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 70791-7409 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 225-654-5481 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 22852 PLANK RD |
Practice Address - Street 2: | |
Practice Address - City: | ZACHARY |
Practice Address - State: | LA |
Practice Address - Zip Code: | 70791-7409 |
Practice Address - Country: | US |
Practice Address - Phone: | 225-654-5481 |
Practice Address - Fax: | 225-654-5432 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-02-12 |
Last Update Date: | 2009-02-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
LA | 5047 | 251C00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251C00000X | Agencies | Day Training, Developmentally Disabled Services |