Healthcare Provider Details

I. General information

NPI: 1871859827
Provider Name (Legal Business Name): LOUISIANA SPECIAL NEEDS CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 04/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7591 I 49 S SERVICE RD
OPELOUSAS LA
70570-8154
US

IV. Provider business mailing address

7591 I 49 S SERVICE RD
OPELOUSAS LA
70570-8154
US

V. Phone/Fax

Practice location:
  • Phone: 337-407-2410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number554472
License Number StateLA

VIII. Authorized Official

Name: TAMMY ROBERT
Title or Position: OWNER/SECRETARY
Credential:
Phone: 337-407-2410