Healthcare Provider Details

I. General information

NPI: 1427061167
Provider Name (Legal Business Name): HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 NINTH ST
JENA LA
71342-2780
US

IV. Provider business mailing address

PO BOX 2780
JENA LA
71342-2780
US

V. Phone/Fax

Practice location:
  • Phone: 318-992-9200
  • Fax: 318-992-9280
Mailing address:
  • Phone: 318-992-9200
  • Fax: 318-992-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number66
License Number StateLA

VIII. Authorized Official

Name: MRS. ALLYSON C. FANNIN
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA, CFO
Phone: 318-992-9200