Organization
NORMAL LIFE OF LAFAYETTE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY A PANK (PARALEGAL)
(502) 394-2100
Entity
Organization
Contact information
Practice address
2895 HIGHWAY 190, SUITES A 1-2, MANDEVILLE, LA 70471-3414
(985) 674-4177
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(502) 394-2100
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1717274
—
LA
Enumeration date
11/28/2006
Last updated
08/05/2025
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