Healthcare Provider Details

I. General information

NPI: 1245864354
Provider Name (Legal Business Name): OUACHITA COUNCIL ON THE AGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 FERRAND ST
MONROE LA
71201-3248
US

IV. Provider business mailing address

2407 FERRAND ST
MONROE LA
71201-3248
US

V. Phone/Fax

Practice location:
  • Phone: 318-387-0535
  • Fax:
Mailing address:
  • Phone: 318-387-0535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LYNDA MCGEHEE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 318-387-0535