Healthcare Provider Details

I. General information

NPI: 1831676170
Provider Name (Legal Business Name): LOUISIANA UNITED METHODIST CHILDREN AND FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1523 HIGHWAY 563
DUBACH LA
71235
US

IV. Provider business mailing address

904 DEVILLE LN
RUSTON LA
71270-6313
US

V. Phone/Fax

Practice location:
  • Phone: 318-777-3460
  • Fax: 318-777-9377
Mailing address:
  • Phone: 318-255-5020
  • Fax: 318-255-6623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JAN ALEXANDER YATES
Title or Position: DIRECTOR HEALTH INFO. MANAGEMENT
Credential:
Phone: 318-255-5020