Healthcare Provider Details

I. General information

NPI: 1366978884
Provider Name (Legal Business Name): LOUISIANA ASSISTIVE TECHNOLOGY ACCESS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3042 OLD FORGE DR STE. D
BATON ROUGE LA
70808-3181
US

IV. Provider business mailing address

3042 OLD FORGE DR STE. D
BATON ROUGE LA
70808-3181
US

V. Phone/Fax

Practice location:
  • Phone: 225-925-9500
  • Fax: 225-925-9560
Mailing address:
  • Phone: 225-925-9500
  • Fax: 225-925-9560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. YAKIMA K BLACK
Title or Position: PRESIDENT & CEO
Credential:
Phone: 225-925-9500