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General NPI Number Information
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NPI Number | 1467980037
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Entity Type | Organization
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Legal Business Name | DIMENSIONAL BEHAVIORAL HEALTH SERVICES INCORPORATION
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Dates
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Enumeration Date | 05/26/2017
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Last Update Date | 05/26/2017
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Provider Practice Location Address
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Address Line | 3600 JACKSON ST STE 111B
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3000
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Country | US
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Telephone | 318-704-6515
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Fax | 318-704-6513
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Provider Business Mailing Address
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Address Line | PO BOX 1245
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City | ALEXANDRIA
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State | LA
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Zip | 71309-1245
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | PASSION LACOLE TAYLOR PAYNE
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Credential |
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Telephone | 318-792-8448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | LA
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