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Organization

LOUISIANA COMMUNITY CARE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ALBERT E BLACKMAN (ADMINISTRATOR)
(318) 640-2953
Entity
Organization

Contact information

Practice address
5803 MONROE HWY, BALL, LA 71405-3362
(318) 640-2953
(318) 641-1976
Mailing address
PO BOX 710, BALL, LA 71405-0710
(318) 640-2953
(318) 641-1976

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
522
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1162221
LA
01
1171786
LT-PCS PROVIDER NUMBER
LA
01
1475556
NOW PROFESSIONAL #
LA
01
1475793
NOW PROFESSIONAL RN #
LA
01
1476170
NOW PROFESSIONAL LPN #
LA
01
1534781
NOW PROFESSIONAL #
LA
05
1713333
LA
05
1717673
LA
05
1717681
LA
05
1717886
LA
05
1719358
LA
05
1910015
LA
05
1910023
LA
05
1953954
LA
Enumeration date
08/09/2005
Last updated
08/22/2020
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