Healthcare Provider Details

I. General information

NPI: 1710989066
Provider Name (Legal Business Name): LAFAYETTE HEALTH VENTURES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 09/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1438 S COLLEGE RD
LAFAYETTE LA
70503-2912
US

IV. Provider business mailing address

PO BOX 53092
LAFAYETTE LA
70505-3092
US

V. Phone/Fax

Practice location:
  • Phone: 337-289-8967
  • Fax: 337-289-8968
Mailing address:
  • Phone: 337-289-8977
  • Fax: 337-289-8970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberS10026
License Number StateLA

VIII. Authorized Official

Name: MRS. CAROLYN HUVAL
Title or Position: VICE PRESIDENT / LHVI
Credential:
Phone: 337-289-8969