NPIMap

Organization Active NPI

CD&J Management, LLC

Doing business as Optimum Personal Care Services

  • Preferred Provider Organization
  • Lafayette, LA
National Provider Identifier
1114049699
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
11117 Issued in LA
Legal business name
CD&J MANAGEMENT, LLC
Doing business as
Optimum Personal Care Services
Practice address
920 W Pinhook Rd
Suite 226
Lafayette, LA 70503-2455
Phone
(337) 593-8444
Fax
(337) 593-9966
NPI assigned
Apr 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Delilah Mouton Broussard
Title
Executive Director
Phone
(337) 593-8444

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 11117 LA Primary
Preferred Provider Organization 305R00000X 12067 LA
Preferred Provider Organization 305R00000X 12068 LA

Addresses

Primary practice location

920 W Pinhook Rd
Suite 226
Lafayette, LA 70503-2455

Mailing address

920 W Pinhook Rd
Suite 226
Lafayette, LA 70503-2455
Phone (337) 593-8444

Other identifiers 3

IdentifierTypeStateIssuer
1466093MedicaidLA
1776785MedicaidLA
1778371MedicaidLA

Other names 1

  • Optimum Personal Care Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CDJ Management LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

920 W Pinhook Rd
Ste 226
Lafayette, LA 70503
Phone (337) 593-8444

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114049699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 W PINHOOK RD",
            "address_2": "SUITE 226",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032455",
            "telephone_number": "337-593-8444",
            "fax_number": "337-593-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W PINHOOK RD",
            "address_2": "SUITE 226",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032455",
            "telephone_number": "337-593-8444",
            "fax_number": "337-593-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CD&J MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "DELILAH",
        "authorized_official_middle_name": "MOUTON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "337-593-8444",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "LA",
            "license": "11117",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "LA",
            "license": "12067",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "LA",
            "license": "12068",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1466093",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1776785",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1778371",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimum Personal Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.