Organization
ST JOHN ARC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH J BABIN (EXECUTIVE DIRECTOR)
(985) 652-5706
Entity
Organization
Contact information
Practice address
101 BAMBOO RD, LA PLACE, LA 70068-6457
(985) 652-5706
(985) 652-2536
Mailing address
101 BAMBOO RD, LA PLACE, LA 70068-6457
(985) 652-5706
(985) 652-2536
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
ADC 2234
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1955761
—
LA
Enumeration date
04/16/2007
Last updated
08/22/2020
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