Calcasieu Multi-Handicapped Center, LLC

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Vinton, LA

NPI 1124010236 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1124010236
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
755 (LA)
Legal business name
CALCASIEU MULTI-HANDICAPPED CENTER, LLC
Practice address
1223 Fancher St
Vinton, LA 70668-4319
Phone
(337) 589-9386
NPI assigned
Aug 16, 2005
Organization subpart
No

Authorized official

Name
Elizabeth Fellows
Title
Ceo
Phone
(816) 444-0900

Corporate family (same tax ID) 5

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

National Provider Directory

Tax ID family
Calcasieu Group Home I (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 755 LA Yes

Addresses

Primary practice location

1223 Fancher St
Vinton, LA 70668-4319

Mailing address

1223 Fancher St
Vinton, LA 70668-4319
Phone (337) 589-9386

Other identifiers

IdentifierTypeStateIssuer
1713091MedicaidLA

Other names

  • CALCASIEU GROUP HOME V Doing business as

Other providers in Vinton, LA

All providers in Vinton, LA · Intellectual Disabilities Intermediate Care Facility in Louisiana

Sources for this page

Verify at the official NPI Registry.