Organization
NORMAL LIFE OF LOUISIANA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEENA OMBRES (PRIVACY OFFICER)
(502) 394-2387
Entity
Organization
Contact information
Practice address
2895 HIGHWAY 190, SUITES A 1-2, MANDEVILLE, LA 70471-3414
(985) 674-4177
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1716316
—
LA
Enumeration date
12/11/2006
Last updated
12/13/2007
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