Organization Active NPI

Goodwill Industries of Acadiana, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Lafayette, LA
National Provider Identifier
1407172125
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
ADC8178 Issued in LA
Legal business name
GOODWILL INDUSTRIES OF ACADIANA, INC.
Practice address
1225 Kaliste Saloom Rd
Lafayette, LA 70508-5707
Phone
(337) 765-7650
Fax
(337) 765-7659
NPI assigned
Apr 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Authorized official

Name
Mrs. Katherin Boudreaux
Title
Director of Supported Employment
Phone
(337) 765-7650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X ADC8178 LA Primary

Addresses

Primary practice location

1225 Kaliste Saloom Rd
Lafayette, LA 70508-5707

Mailing address

1225 Kaliste Saloom Rd
P.O. Box 62270
Lafayette, LA 70508-5707
Phone (337) 765-7650

Other identifiers 1

IdentifierTypeStateIssuer
2343084MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Goodwill Industries of Acadiana Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409011200000",
    "number": "1407172125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 KALISTE SALOOM RD",
            "address_2": "P.O. BOX 62270",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085707",
            "telephone_number": "337-765-7650",
            "fax_number": "337-765-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085707",
            "telephone_number": "337-765-7650",
            "fax_number": "337-765-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL INDUSTRIES OF ACADIANA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2014-08-26",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "KATHERIN",
        "authorized_official_title_or_position": "DIRECTOR OF SUPPORTED EMPLOYMENT",
        "authorized_official_telephone_number": "337-765-7650",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "LA",
            "license": "ADC8178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2343084",
            "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 Aug 26, 2014; 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.