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General NPI Number Information
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NPI Number | 1407038672
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Entity Type | Organization
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Legal Business Name | NELLIE BYERS TRAINING CENTER INC
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 640 AVENUE V
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City | BOGALUSA
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State | LA
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Zip | 70427
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Country | US
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Telephone | 985-735-5216
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Fax | 985-735-1923
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Provider Business Mailing Address
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Address Line | 640 AVENUE V
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City | BOGALUSA
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State | LA
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Zip | 70427
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Country | US
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Telephone | 985-735-5216
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Fax | 985-735-1923
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Authorized Official
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Title or Position | PRESIDENT OF THE BOARD
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Name | LANCE S DAVIS
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Credential | MBA
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Telephone | 985-735-6555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | LA
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