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General NPI Number Information
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NPI Number | 1639349251
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Entity Type | Organization
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Legal Business Name | NORMAL LIFE OF LAFAYETTE, INC
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 3220 2ND AVE
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City | LAKE CHARLES
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State | LA
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Zip | 70601-8922
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Country | US
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Telephone | 337-478-2299
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Fax |
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Provider Business Mailing Address
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Address Line | 805 N WHITTINGTON PKWY STE 400
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City | LOUISVILLE
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State | KY
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Zip | 40222-7102
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Country | US
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Telephone | 502-394-2100
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Fax |
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Authorized Official
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Title or Position | PARALEGAL
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Name | MARY A PANK
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Credential |
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Telephone | 502-394-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | LA
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