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General NPI Number Information
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NPI Number | 1356384333
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Entity Type | Organization
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Legal Business Name | OUTREACH BEHAVIORAL HEALTH SOLUTIONS
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1810 FLORIDA BLVD SUITE D
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-4951
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Country | US
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Telephone | 225-791-4552
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Fax | 225-791-4552
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Provider Business Mailing Address
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Address Line | 1810 FLORIDA BLVD SUITE D
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-4951
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Country | US
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Telephone | 225-791-4552
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Fax | 225-791-4552
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Authorized Official
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Title or Position | OWNER
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Name | MR. W RAY ROGERS
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Credential | RN
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Telephone | 225-667-2792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PENDING
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License Number State | LA
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