Healthcare Provider Details

I. General information

NPI: 1013057660
Provider Name (Legal Business Name): DEPARTMENT OF HEALTH AND HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 MEDICAL DRIVE
NATCHITOCHES LA
71457-6052
US

IV. Provider business mailing address

210 MEDICAL DRIVE
NATCHITOCHES LA
71457-6052
US

V. Phone/Fax

Practice location:
  • Phone: 318-357-3122
  • Fax: 318-357-3240
Mailing address:
  • Phone: 318-357-3122
  • Fax: 318-357-3240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLA DHH 93
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number093
License Number StateLA

VIII. Authorized Official

Name: MS. ALLIE D. ALLEN
Title or Position: ADMINISTRATOR PROGRAM MANAGER
Credential:
Phone: 318-676-5111