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NPI Code Detail

MEDICARE: THEOPHILUS COMMUNITY PROGRAMS, INC.

MEDICARE: THEOPHILUS COMMUNITY PROGRAMS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency7413LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093907396
Entity Type Code : Organization
Provider Name (Legal Business Name) : THEOPHILUS COMMUNITY PROGRAMS, INC.
Provider Business Mailing Address
First Line : PO BOX 2900
Second Line :
City : GRETNA
State : LA
Zip : 70054-2900
Country : US
Telephone Number : 225-928-1730
Fax Number : 225-928-1824
Provider Business Practice Location Address
First Line : 1000 N MORRISON BLVD
Second Line : SUITE J
City : HAMMOND
State : LA
Zip : 70401-2233
Country : US
Telephone Number : 985-429-1002
Fax Number : 985-429-1448
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. SHEILA MORRIS BROWN
Credential : MSW, GSW
Telephone Number : 225-928-1730
Provider Enumeration Date : 08/10/2007
Last Update Date : 08/10/2007

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Directions to “THEOPHILUS COMMUNITY PROGRAMS, INC. ” Practice Location

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