Provider Demographics
NPI:1861600363
Name:WESTBANK ARC
Entity type:Organization
Organization Name:WESTBANK ARC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARASCALCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-361-1131
Mailing Address - Street 1:523 COOK ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-3204
Mailing Address - Country:US
Mailing Address - Phone:504-361-1131
Mailing Address - Fax:504-361-9616
Practice Address - Street 1:523 COOK ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-3204
Practice Address - Country:US
Practice Address - Phone:504-361-1131
Practice Address - Fax:504-361-9616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14234251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1936863Medicaid
LA1962597Medicaid