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General NPI Number Information
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NPI Number | 1568676286
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Entity Type | Organization
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Legal Business Name | LOUISIANA SPECIAL EDUCATION CENTER
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5400 COLISEUM BLVD
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3705
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Country | US
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Telephone | 318-487-5484
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Fax | 318-487-5002
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Provider Business Mailing Address
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Address Line | 5400 COLISEUM BLVD
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3705
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Country | US
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Telephone | 318-487-5484
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Fax | 318-487-5002
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Authorized Official
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Title or Position | INTERIM DIRECTOR
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Name | MR. MICHAEL A JOINER
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Credential |
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Telephone | 318-484-2223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number | 1712094
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License Number State | LA
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