Healthcare Provider Details

I. General information

NPI: 1871648931
Provider Name (Legal Business Name): DEPARTMENT OF HEALTH & HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 RINGGOLD AVENUE
COUSHATTA LA
71019-1016
US

IV. Provider business mailing address

1313 RINGGOLD AVENUE
COUSHATTA LA
71019-1016
US

V. Phone/Fax

Practice location:
  • Phone: 318-932-4029
  • Fax: 318-932-5914
Mailing address:
  • Phone: 318-932-4029
  • Fax: 318-932-5914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number93
License Number StateLA

VIII. Authorized Official

Name: MS. ALLIE D. ALLEN
Title or Position: DIR. OF OPERATIONS
Credential:
Phone: 318-676-5160