Healthcare Provider Details

I. General information

NPI: 1285699629
Provider Name (Legal Business Name): DEPARTMENT OF HEALTH AND HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 08/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 NATCHITOCHES ST
WEST MONROE LA
71292-3751
US

IV. Provider business mailing address

1416 NATCHITOCHES ST
WEST MONROE LA
71292-3751
US

V. Phone/Fax

Practice location:
  • Phone: 318-362-5430
  • Fax: 318-362-5428
Mailing address:
  • Phone: 318-362-5430
  • Fax: 318-362-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number286
License Number StateLA

VIII. Authorized Official

Name: MRS. PHYLLIS JERRI PARKS
Title or Position: OAD/REGIONAL ADMINISTRATOR
Credential: MSW
Phone: 318-362-3270