Healthcare Provider Details

I. General information

NPI: 1811074719
Provider Name (Legal Business Name): SPECIAL EDUCATION DISTRICT 1 OF LAFOURCHE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 WEST AVENUE D
CUT OFF LA
70345
US

IV. Provider business mailing address

PO BOX 405
CUT OFF LA
70345-0405
US

V. Phone/Fax

Practice location:
  • Phone: 985-632-5671
  • Fax: 985-632-5659
Mailing address:
  • Phone: 985-632-5671
  • Fax: 985-632-5659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License NumberADC 2285
License Number StateLA

VIII. Authorized Official

Name: LESTER ADAMS
Title or Position: EXEUCTIVE DIRECTOR
Credential:
Phone: 985-632-5671