MEDICARE: VOLUNTEERS OF AMERICA OF NORTH LOUISIANA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	8145	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245352723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOLUNTEERS OF AMERICA OF NORTH LOUISIANA

Provider Business Mailing Address
First Line	:	360 JORDAN STREET
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71101
Country	:	US
Telephone Number	:	318-221-2669
Fax Number	:	318-429-7502

Provider Business Practice Location Address
First Line	:	1554 MAGNOLIA AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71101
Country	:	US
Telephone Number	:	318-213-1654
Fax Number	:	318-429-6929

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. CHARLES MEEHAN
Credential	:
Telephone Number	:	318-221-2669

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	09/09/2020

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