Healthcare Provider Details

I. General information

NPI: 1518139146
Provider Name (Legal Business Name): DEPARTMENT OF HEALTH AND HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2008
Last Update Date: 11/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 E 123RD ST
GALLIANO LA
70354-4223
US

IV. Provider business mailing address

127 E 123RD ST
GALLIANO LA
70354-4223
US

V. Phone/Fax

Practice location:
  • Phone: 985-632-2175
  • Fax: 985-632-8651
Mailing address:
  • Phone: 985-632-2175
  • Fax: 985-632-8651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number86
License Number StateLA

VIII. Authorized Official

Name: MR. KENT ST. GERMAIN
Title or Position: MENTAL HEALTH REGIONAL DIRECTOR
Credential: LPC, LMFT
Phone: 985-857-3673