Organization
NORMAL LIFE OF LAFAYETTE, INC.
Active
Other names
Fairway Community Home
Organization subpart
No
Provider details
NPI number
Authorized official
MARY A PANK (PARALEGAL)
(502) 394-2100
Entity
Organization
Contact information
Practice address
602 FAIRWAY DR, THIBODAUX, LA 70301-3726
(337) 233-2731
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(502) 394-2100
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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