MEDICARE: LOUISIANA YOUTH AND FAMILY NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	302F00000X	Exclusive Provider Organization

General Provider Information

NPI Number	:	1386503480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUISIANA YOUTH AND FAMILY NETWORK

Provider Business Mailing Address
First Line	:	PO BOX 77053
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70879-7053
Country	:	US
Telephone Number	:	225-325-0859
Fax Number	:	225-380-1326

Provider Business Practice Location Address
First Line	:	3020 KNIGHT ST STE 200
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2554
Country	:	US
Telephone Number	:	318-408-9101
Fax Number	:	225-380-1326

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	STEPHANIE ROACH
Credential	:	MBA, MSW, LMSW
Telephone Number	:	225-278-8375

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	03/08/2026

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