Organization · Type 2 NPI

North Lake Supports & Services Center

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Albany, LA

NPI number 1801070065 Active

Practice location

30199 Julia Street
Albany, LA 70711

Call (225) 567-3111 Map

Fax (225) 567-2017

Mailing address

45439 Live Oak Dr
Hammond, LA 70401-4526

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	APPLIED FOR (LA)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Other intellectual and/or developmental disabilities community based residential treatment facility providers in Albany

Evergreen Presbyterian Ministries, Inc.Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Albany, LA NPI 1801113949

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NPI record

NPI: 1801070065
Entity type: Organization (Type 2)
Issued: Dec 24, 2007
Last updated: Dec 24, 2007
Status: Active
Subpart: Yes of La Dept of Health & Hospitals

Other names

<unavail>
Julia St. Community Home · doing business as

Authorized official

Mr. Kindred Hodge
Administrator
(225) 567-3111

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1801070065

North Lake Supports & Services Center's National Provider Identifier is 1801070065, issued on Dec 24, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Albany, LA. The record was last updated on Dec 24, 2007.