Provider Demographics
NPI:1932418902
Name:CRESTWORTH LEARNING ACADEMY INC.
Entity Type:Organization
Organization Name:CRESTWORTH LEARNING ACADEMY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DATA MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:EWINEYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-775-6845
Mailing Address - Street 1:10650 AVENUE F
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-2501
Mailing Address - Country:US
Mailing Address - Phone:225-775-6845
Mailing Address - Fax:225-775-0051
Practice Address - Street 1:9450 SCENIC HWY STE B-1
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807-3762
Practice Address - Country:US
Practice Address - Phone:225-775-4359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5443251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)