Organization
INTERLINK HOMEAND COMMUNITY BASED WAIVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAIGE ANN OKPALOBI (ADMINISTRATOR)
(985) 652-1847
Entity
Organization
Contact information
Practice address
75 DOMINICAN RD, SUITE 201, LA PLACE, LA 70068-3400
(985) 652-1847
(985) 652-1897
Mailing address
75 DOMINICAN RD, SUITE 201, LA PLACE, LA 70068-3400
(985) 652-1847
(985) 652-1897
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLIED FOR
—
LA
Enumeration date
11/19/2007
Last updated
11/19/2007
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