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General NPI Number Information
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NPI Number | 1649453879
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Entity Type | Organization
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Legal Business Name | CENTER FOR PERSONAL DEVELOPMENT
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1701 LAMY LN
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City | MONROE
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State | LA
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Zip | 71201-3737
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Country | US
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Telephone | 318-329-0240
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Fax | 318-329-0239
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Provider Business Mailing Address
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Address Line | PO BOX 4381
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City | MONROE
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State | LA
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Zip | 71211-4381
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Country | US
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Telephone | 318-512-1257
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Fax | 318-343-4393
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS LORIA S. PIERCE
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Credential | LMFT
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Telephone | 318-512-1257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 7268
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License Number State | LA
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