Blessed Kidz Therapeutic Group Home LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

BLESSED KIDZ THERAPEUTIC GROUP HOME LLC

Practice address

2023 Saint Charles St
Jeanerette, LA 70544-4225

Phone

(337) 564-3504

NPI assigned

Oct 6, 2026

Last updated

Oct 6, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laderical Deldra Wagner, JD

Title

Executive Director

Phone

(337) 380-3950

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1791244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791244800000",
    "number": "1427952266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 SAINT CHARLES ST",
            "city": "JEANERETTE",
            "state": "LA",
            "postal_code": "705444225",
            "telephone_number": "337-564-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 SAINT CHARLES ST",
            "city": "JEANERETTE",
            "state": "LA",
            "postal_code": "705444225",
            "telephone_number": "337-564-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESSED KIDZ THERAPEUTIC GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-06",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-05",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "LADERICAL",
        "authorized_official_middle_name": "DELDRA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "337-380-3950",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.