Healthcare Provider Details

I. General information

NPI: 1013899541
Provider Name (Legal Business Name): LOUISIANA OPPORTUNITY ZONE FUND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9373 BARINGER FOREMAN RD BLDG 2
BATON ROUGE LA
70817-6200
US

IV. Provider business mailing address

9373 BARINGER FOREMAN RD BLDG 2
BATON ROUGE LA
70817-6200
US

V. Phone/Fax

Practice location:
  • Phone: 225-304-6476
  • Fax: 225-755-2147
Mailing address:
  • Phone: 225-304-6476
  • Fax: 225-755-2147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ROBERT JOSEPH LANDRY III
Title or Position: MANAGER
Credential:
Phone: 225-304-6476