Healthcare Provider Details

I. General information

NPI: 1528320421
Provider Name (Legal Business Name): DHH/OPH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 06/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 LOUISIANA AVE
PORT ALLEN LA
70767-2144
US

IV. Provider business mailing address

685 LOUISIANA AVE
PORT ALLEN LA
70767-2144
US

V. Phone/Fax

Practice location:
  • Phone: 225-342-7527
  • Fax: 225-383-3552
Mailing address:
  • Phone: 225-342-7527
  • Fax: 225-383-3552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number0003305
License Number StateLA

VIII. Authorized Official

Name: MS. DEBORAH A TREUIL
Title or Position: NURSING SUPERVISOR
Credential: RN
Phone: 225-342-7527