LASALLE ASSOCIATION FOR THE DEVELOPMENTALLY DELAYED, INC
Managed Care Organizations at Pepper St, Nebo, LA

License number
Louisiana ADC2324
Category
Managed Care Organizations
Type
Exclusive Provider Organization
Owner
Name: MRS. JUDY JORDAN
Title: ADMINISTRATOR
Phone: (318) 992-6217
Address
Address
1258 Pepper St, Nebo, LA 71342
National Provider ID: 1033258090
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LASALLE ASSOCIATION FOR THE DEVELOPMENTALLY DELAYED, INC

Nebo, LA

Industry:
Specialty Outpatient Clinic
Registration:
Mar 31, 1976
Phone:
(318) 992-6217 (Phone)
Addresses:
1258 Pepper St, Jena, LA 71342 (Physical)
C/O Cleveland Riser, Jena, LA 71342 (Mailing)
State ID:
04603580N
Business type:
Non-Profit Corporation
Secretary/Treasurer, Treasurers:
Cleveland Riser (President), 716 Mcentyre, Jena, LA 71342 (Physical),Tom Watkins (Vice-President), 260 Leonard Rd, Jena, LA 71342 (Physical),Betty Weaver (Director),...

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