Organization
ST. ANGELA MERICI FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COTINA BOUDREAUX (DIRECTOR)
(337) 589-1919
Entity
Organization
Contact information
Practice address
1340 HORRIDGE ST, VINTON, LA 70668-4532
(337) 589-1919
(337) 589-6604
Mailing address
1340 HORRIDGE ST, VINTON, LA 70668-4532
(337) 589-1919
(337) 589-6604
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
ADC11233
LA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
PCA 6705
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003081233
—
LA
05
—
1396956207
—
LA
05
—
1467627604
—
LA
05
—
1760657993
—
LA
Enumeration date
05/24/2007
Last updated
03/01/2012
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