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Organization
NORMAL LIFE OF LAFAYETTE, INC.
Active
Organization
NORMAL LIFE OF LAFAYETTE, INC.
Active
Other names
Braewood Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (CHIEF REGULATORY OFFICER SR ASST GC)
(952) 836-2234
Entity
Organization
Contact information
Practice address
773 BRAEWOOD AVE, BATON ROUGE, LA 70815-7202
(225) 778-5194
Mailing address
6600 FRANCE AVE S STE 350, EDINA, MN 55435-1810
(800) 388-5150
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1716073
VENDOR #
LA
01
—
872
LICENSE NO.
LA
Enumeration date
01/09/2012
Last updated
07/19/2026
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