Provider Demographics
NPI:1104141779
Name:ANOTHER CHANCE ENTERPRISE
Entity type:Organization
Organization Name:ANOTHER CHANCE ENTERPRISE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:318-325-9503
Mailing Address - Street 1:3001 ARMAND ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3754
Mailing Address - Country:US
Mailing Address - Phone:318-325-9503
Mailing Address - Fax:318-325-9504
Practice Address - Street 1:3001 ARMAND ST
Practice Address - Street 2:SUITE E
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3754
Practice Address - Country:US
Practice Address - Phone:318-325-9503
Practice Address - Fax:318-325-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAADC9320251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1245448992Medicaid
LA1326282856Medicaid
LA1669690962Medicaid
LA1083821417Medicaid
LA1548498629Medicaid