NPIMap

Organization Active NPI

Lasting Impression Care, Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Gretna, LA
National Provider Identifier
1003004441
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
PCA 14002 Issued in LA
Legal business name
LASTING IMPRESSION CARE, INC
Practice address
405 Gretna Blvd
Suite 103C
Gretna, LA 70053-4900
Phone
(504) 227-8343
Fax
(504) 227-8540
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Tru'Ieshia Ranee Anderson-Manard
Title
Director
Phone
(504) 227-8343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X PCA 14002 LA Primary

Addresses

Primary practice location

405 Gretna Blvd
Suite 103C
Gretna, LA 70053-4900

Mailing address

405 Gretna Blvd
Suite 103C
Gretna, LA 70053-4900
Phone (504) 227-8343

Other identifiers 1

IdentifierTypeStateIssuer
1709735MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Lasting Impression Care Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1003004441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 GRETNA BLVD",
            "address_2": "SUITE 103C",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700534900",
            "telephone_number": "504-227-8343",
            "fax_number": "504-227-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 GRETNA BLVD",
            "address_2": "SUITE 103C",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700534900",
            "telephone_number": "504-227-8343",
            "fax_number": "504-227-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASTING IMPRESSION CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON-MANARD",
        "authorized_official_first_name": "TRU'IESHIA",
        "authorized_official_middle_name": "RANEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "504-227-8343",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "PCA 14002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1709735",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.