Organization
DDMS OF LOUISIANA NO 2, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP& SR. ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
8280 YMCA PLAZA DR BLDG 9, BATON ROUGE, LA 70810-0927
(225) 767-2344
(225) 767-8068
Mailing address
313 CONGRESS ST, BOSTON, MA 02210-1218
(800) 388-5150
(617) 790-4271
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
340
LA
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1719218
—
LA
Enumeration date
05/11/2007
Last updated
11/20/2023
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