NPIMap

Organization Active NPI

Angel Manor

  • Developmentally Disabled Services Day Training Agency
  • Lafayette, LA
National Provider Identifier
1194990879
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
10343 Issued in LA
Legal business name
ANGEL MANOR
Practice address
708 S Washington St
Lafayette, LA 70501-6810
Phone
(337) 232-7761
Fax
(337) 232-7762
NPI assigned
Apr 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Mr. John Samuel Ford
Title
Administrator/Owner
Phone
(337) 232-7761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 10343 LA Primary

Addresses

Primary practice location

708 S Washington St
Lafayette, LA 70501-6810

Mailing address

708 S Washington St
Lafayette, LA 70501-6810
Phone (337) 232-7761

Other identifiers 3

IdentifierTypeStateIssuer
1178179MedicaidLA
1000451MedicaidLA
1334490MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Angel Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

708 S Washington St
Lafayette, LA 70501
Phone (337) 232-7761

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1194990879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 S WASHINGTON ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016810",
            "telephone_number": "337-232-7761",
            "fax_number": "337-232-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 S WASHINGTON ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016810",
            "telephone_number": "337-232-7761",
            "fax_number": "337-232-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "337-232-7761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "LA",
            "license": "10343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1178179",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000451",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1334490",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 24, 2008; 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.