Provider Demographics
NPI:1912652058
Name:AFFILIATED BLIND OF LOUISIANA TRAINING CENTER
Entity Type:Organization
Organization Name:AFFILIATED BLIND OF LOUISIANA TRAINING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-234-6492
Mailing Address - Street 1:409 W SAINT MARY BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4639
Mailing Address - Country:US
Mailing Address - Phone:337-234-6492
Mailing Address - Fax:337-232-4244
Practice Address - Street 1:409 W SAINT MARY BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4639
Practice Address - Country:US
Practice Address - Phone:337-234-6492
Practice Address - Fax:337-232-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation