Organization
SOUTHERN INGENUITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARYN R. CLARK (PRESIDENT)
(318) 927-5068
Entity
Organization
Contact information
Practice address
598 HARMON LOOP, HOMER, LA 71040-5830
(318) 927-5046
(318) 927-5055
Mailing address
PO BOX 38, HOMER, LA 71040-0038
(318) 927-5046
(318) 927-5055
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1971243
—
LA
Enumeration date
03/14/2008
Last updated
03/14/2008
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