Provider Demographics
NPI:1770603094
Name:ST. LANDRY PARISH COMMUNITY ACTION AGENCY
Entity type:Organization
Organization Name:ST. LANDRY PARISH COMMUNITY ACTION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:337-948-4119
Mailing Address - Street 1:1065 HIGHWAY 749 STE E
Mailing Address - Street 2:P.O. DRAWER 1510
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-0005
Mailing Address - Country:US
Mailing Address - Phone:337-948-3651
Mailing Address - Fax:337-948-4153
Practice Address - Street 1:1065 HIGHWAY 749 STE E
Practice Address - Street 2:P.O. DRAWER 1510
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-0005
Practice Address - Country:US
Practice Address - Phone:337-948-3651
Practice Address - Fax:337-948-4153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1365521Medicaid