Organization
ANGEL MANOR LLC
Active
Other names
Family First Intensive Behavioral Systems
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN FORD JR. (ADMINISTRATOR/OWNER)
(337) 232-7761
Entity
Organization
Contact information
Practice address
708 S WASHINGTON ST, LAFAYETTE, LA 70501-6810
(337) 232-7761
Mailing address
708 S WASHINGTON ST, LAFAYETTE, LA 70501-6810
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
5049
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134490
—
LA
Enumeration date
12/16/2009
Last updated
12/16/2009
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