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General NPI Number Information
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NPI Number | 1508671116
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Entity Type | Organization
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Legal Business Name | NORTHEAST DELTA HUMAN SERVICES AUTHORITY
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 4781 S GRAND ST
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City | MONROE
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State | LA
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Zip | 71202-6403
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Country | US
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Telephone | 318-362-3270
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Fax | 318-362-5051
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Provider Business Mailing Address
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Address Line | 4781 S GRAND ST
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City | MONROE
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State | LA
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Zip | 71202-6403
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Country | US
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Telephone | 318-362-3270
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Fax | 318-362-5051
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Authorized Official
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Title or Position | ADMINISTRATIVE PROGRAM MANAGER 2
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Name | OCTAVIA GREEN
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Credential |
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Telephone | 318-362-3270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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