Healthcare Provider Details

I. General information

NPI: 1386898120
Provider Name (Legal Business Name): VOLUNTEERS OF AMERICA, GBR., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 EXCHANGE PL
LAFAYETTE LA
70503-2510
US

IV. Provider business mailing address

3949 NORTH BLVD
BATON ROUGE LA
70806-3827
US

V. Phone/Fax

Practice location:
  • Phone: 337-234-5715
  • Fax: 337-210-1192
Mailing address:
  • Phone: 225-387-0061
  • Fax: 225-381-7963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number9141
License Number StateLA

VIII. Authorized Official

Name: JANE SHANK
Title or Position: CEO
Credential:
Phone: 225-387-0061