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General NPI Number Information
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NPI Number | 1326474107
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Entity Type | Organization
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Legal Business Name | MADISON/TALLULAH EDUCATION CENTER
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Dates
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Enumeration Date | 09/24/2013
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 1206 NORTH CEDAR ST.
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City | TALLULAH
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State | LA
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Zip | 71284
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Country | US
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Telephone | 318-574-0029
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Fax | 318-574-0073
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Provider Business Mailing Address
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Address Line | PO BOX 312
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City | TALLULAH
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State | LA
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Zip | 71284-0312
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Country | US
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Telephone | 318-574-0029
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Fax | 318-574-0073
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFGICER
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Name | DR. PATRICIA CANDLER
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Credential | EDD
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Telephone | 318-574-0029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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