Healthcare Provider Details

I. General information

NPI: 1265419105
Provider Name (Legal Business Name): ISLAND ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17321 CLINE DR
MAUREPAS LA
70449-5128
US

IV. Provider business mailing address

17321 CLINE DR
MAUREPAS LA
70449-5128
US

V. Phone/Fax

Practice location:
  • Phone: 225-698-9379
  • Fax: 225-698-3651
Mailing address:
  • Phone: 225-698-9379
  • Fax: 225-698-3651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number10359
License Number StateLA

VIII. Authorized Official

Name: MS. JOANN E PICOU
Title or Position: OWNER DIRECTOR
Credential:
Phone: 225-698-9379