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General NPI Number Information
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NPI Number | 1215033535
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Entity Type | Organization
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Legal Business Name | CENTRAL LA STATE HOSPITAL
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 6250 ESLER FIELD ROAD
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City | PINEVILLE
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State | LA
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Zip | 71360
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Country | US
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Telephone | 318-484-6200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5031
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City | PINEVILLE
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State | LA
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Zip | 71361-5031
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Country | US
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Telephone | 318-484-6200
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Fax | 318-484-6879
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Authorized Official
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Title or Position | HOSPITAL ADMINISTRATOR
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Name | CELESTE GAUTHIER
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Credential |
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Telephone | 318-484-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 217
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License Number State | LA
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