Healthcare Provider Details

I. General information

NPI: 1023291291
Provider Name (Legal Business Name): NORMAL LIFE OF LAFAYETTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 12/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 LA RUE FRANCE SUITE A
LAFAYETTE LA
70508-3104
US

IV. Provider business mailing address

9901 LINN STATION RD
LOUISVILLE KY
40223-3808
US

V. Phone/Fax

Practice location:
  • Phone: 337-223-2731
  • Fax:
Mailing address:
  • Phone: 800-866-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateLA

VIII. Authorized Official

Name: MS. DEENA OMBRES
Title or Position: PRIVACY OFFICER
Credential:
Phone: 502-394-2387