NPIMap

Organization Active NPI

Angel Manor LLC

  • Developmentally Disabled Services Day Training Agency
  • Lafayette, LA
National Provider Identifier
1962731216
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
5049 Issued in LA
Legal business name
ANGEL MANOR LLC
Practice address
708 S Washington St
Lafayette, LA 70501-6810
Phone
(337) 232-7761
NPI assigned
Dec 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 5049 LA Primary

Addresses

Primary practice location

708 S Washington St
Lafayette, LA 70501-6810

Mailing address

708 S Washington St
Lafayette, LA 70501-6810

Other identifiers 1

IdentifierTypeStateIssuer
1134490MedicaidLA

Other names 1

  • Family First Intensive Behavioral Systems Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Angel Manor 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.

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1962731216",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "337-232-7761",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "LA",
            "license": "5049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134490",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family First Intensive Behavioral Systems",
            "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 Dec 16, 2009; 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.