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General NPI Number Information
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NPI Number | 1861600363
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Entity Type | Organization
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Legal Business Name | WESTBANK ARC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 523 COOK ST
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City | GRETNA
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State | LA
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Zip | 70053-3204
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Country | US
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Telephone | 504-361-1131
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Fax | 504-361-9616
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Provider Business Mailing Address
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Address Line | 523 COOK ST
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City | GRETNA
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State | LA
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Zip | 70053-3204
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Country | US
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Telephone | 504-361-1131
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Fax | 504-361-9616
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MARY MARASCALCO
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Credential |
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Telephone | 504-361-1131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 14234
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License Number State | LA
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