Provider Demographics
NPI:1265419105
Name:ISLAND ENTERPRISES INC
Entity type:Organization
Organization Name:ISLAND ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PICOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-698-9379
Mailing Address - Street 1:17321 CLINE DR
Mailing Address - Street 2:
Mailing Address - City:MAUREPAS
Mailing Address - State:LA
Mailing Address - Zip Code:70449-5128
Mailing Address - Country:US
Mailing Address - Phone:225-698-9379
Mailing Address - Fax:225-698-3651
Practice Address - Street 1:17321 CLINE DR
Practice Address - Street 2:
Practice Address - City:MAUREPAS
Practice Address - State:LA
Practice Address - Zip Code:70449-5128
Practice Address - Country:US
Practice Address - Phone:225-698-9379
Practice Address - Fax:225-698-3651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X
LA10359385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1712744Medicaid
LA1542695Medicaid
LA1542679Medicaid
LA1137341Medicaid
LA1712841Medicaid
LA1173240Medicaid
LA1712761Medicaid
LA1173185Medicaid