Provider Demographics
NPI:1871951442
Name:ASSUMPTION COUNCIL ON AGING
Entity type:Organization
Organization Name:ASSUMPTION COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION/ SOCIAL SERVICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTNY
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-369-7961
Mailing Address - Street 1:166 HIGHWAY 1008
Mailing Address - Street 2:
Mailing Address - City:NAPOLEONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70390-2009
Mailing Address - Country:US
Mailing Address - Phone:985-369-7961
Mailing Address - Fax:985-369-9884
Practice Address - Street 1:166 HIGHWAY 1008
Practice Address - Street 2:
Practice Address - City:NAPOLEONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70390-2009
Practice Address - Country:US
Practice Address - Phone:985-369-7961
Practice Address - Fax:985-369-9884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA270738123343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1612197Medicaid