Provider Demographics
NPI:1447811831
Name:LOUISIANA ASSISTIVE TECH ACCESS NETWORK
Entity type:Organization
Organization Name:LOUISIANA ASSISTIVE TECH ACCESS NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:YAKIMA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-925-9500
Mailing Address - Street 1:3042 OLD FORGE DR STE D
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3182
Mailing Address - Country:US
Mailing Address - Phone:225-925-9500
Mailing Address - Fax:
Practice Address - Street 1:10988 N HARRELLS FERRY RD STE 5
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8360
Practice Address - Country:US
Practice Address - Phone:225-925-9500
Practice Address - Fax:225-925-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty