Provider Demographics
NPI:1588953111
Name:GOODWILL INDUSTRIES OF NORTH LOUISIANA, INC.
Entity type:Organization
Organization Name:GOODWILL INDUSTRIES OF NORTH LOUISIANA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-629-5900
Mailing Address - Street 1:800 W 70TH ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-2519
Mailing Address - Country:US
Mailing Address - Phone:318-629-5900
Mailing Address - Fax:
Practice Address - Street 1:800 W 70TH ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-2519
Practice Address - Country:US
Practice Address - Phone:318-629-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services