Organization
SLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENIA RICHARDSON M.ED (PROGRAM DIRECTOR)
(225) 810-9622
Entity
Organization
Contact information
Practice address
2055 WOODDALE BLVD, BATON ROUGE, LA 70806-1516
(225) 810-9622
(225) 927-2464
Mailing address
2055 WOODDALE BLVD, BATON ROUGE, LA 70806-1516
(225) 810-9622
(225) 927-2464
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
11085
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1475220
—
LA
Enumeration date
05/18/2007
Last updated
08/22/2020
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