LASTING IMPRESSION CARE, INC NPI 1003004441

Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities in Gretna, LA

About LASTING IMPRESSION CARE, INC

Lasting Impression Care, Inc is a provider in Gretna, LA. The NPI number assigned to this provider is 1003004441. The practitioner's primary taxonomy code is Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities (320900000X). The provider is registered as an organization and their NPI record was last updated 10 years ago.

NPI1003004441 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameLASTING IMPRESSION CARE, INC
Provider Location Address405 GRETNA BLVD SUITE 103C GRETNA, LA 70053 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address405 GRETNA BLVD SUITE 103C GRETNA, LA 70053 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date10-11-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date10-11-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

LASTING IMPRESSION CARE, INC
405 GRETNA BLVD
SUITE 103C
GRETNA, LA
ZIP 70053
Phone: (504) 227-8343
Fax: (504) 227-8540
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Mailing Address

LASTING IMPRESSION CARE, INC
405 GRETNA BLVD
SUITE 103C
GRETNA, LA
ZIP 70053
Phone: (504) 227-8343
Fax: (504) 227-8540

Primary Taxonomy

Taxonomy Code320900000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationCommunity Based Residential Treatment, Mental Retardation and/or Developmental Disabilities
TypeResidential Treatment Facilities
License No.PCA 14002
License StateLA
Taxonomy DescriptionA home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Authorized Official

Authorized Official NameMRS. TRU'IESHIA RANEE ANDERSON-MANARD Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleDIRECTOR
Authorized Official Phone(504) 227-8343

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1709735MEDICAID (05)LA

Map Location


LASTING IMPRESSION CARE, INC address is 405 GRETNA BLVD SUITE 103C GRETNA, LA 70053

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1043408651LASTING IMPRESSION CARE INC
Organization
Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities405 GRETNA BLVD SUITE 103C
GRETNA, LA 70053
(507) 227-8343
1730377177LASTING IMPRESSION CARE, INC
Organization
Respite Care (Respite Care, Mental Retardation and/or Developmental Disabilities, Child)405 GRETNA BLVD SUITE 103C
GRETNA, LA 70053
(504) 227-8343
1912195355LASTING IMPRESSION CARE, INC
Organization
Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities405 GRETNA BLVD SUITE 103C
GRETNA, LA 70053
(504) 227-8343