Organization
LASALLE ASSOCIATION FOR THE DEVELOPMENTALLY DELAYED, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY JORDAN (ADMINISTRATOR)
(318) 992-6217
Entity
Organization
Contact information
Practice address
1258 PEPPER ST, JENA, LA 71342-4432
(318) 992-6217
(318) 992-0467
Mailing address
1258 PEPPER ST, JENA, LA 71342-4432
(318) 992-6217
(318) 992-0467
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
ADC2324
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1937975
—
LA
Enumeration date
02/06/2007
Last updated
08/22/2020
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