NPIMap

Organization Active NPI

Normal Life of Lafayette, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Greenwell Springs, LA
National Provider Identifier
1073884466
Registry record updated Jul 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
NORMAL LIFE OF LAFAYETTE, INC.
Practice address
12804 Pecos Ave
Greenwell Springs, LA 70739-3047
Phone
(225) 757-6192
NPI assigned
Jan 18, 2012
Last updated
Jul 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2026

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

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
Chief Regulatory Officer Sr Asst GC
Phone
(952) 836-2234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary

Addresses

Primary practice location

12804 Pecos Ave
Greenwell Springs, LA 70739-3047

Mailing address

6600 France Ave S Ste 350
Edina, MN 55435-1810
Phone (800) 388-5150

Other identifiers 2

IdentifierTypeStateIssuer
886OtherLAOLD LICENSE NO.
1717045OtherLAVENDOR #

Other names 1

  • Pecos Group Home Other name

National Provider Directory

National Provider Directory
Tax ID family
Normal Life of Lafayette Inc53 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784419200000",
    "number": "1073884466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 350",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351810",
            "telephone_number": "800-388-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12804 PECOS AVE",
            "city": "GREENWELL SPRINGS",
            "state": "LA",
            "postal_code": "707393047",
            "telephone_number": "225-757-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORMAL LIFE OF LAFAYETTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2026-07-19",
        "certification_date": "2026-07-19",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER SR ASST GC",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD LICENSE NO.",
            "identifier": "886",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VENDOR #",
            "identifier": "1717045",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pecos Group Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenwell Springs, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2026; 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.