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General NPI Number Information
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NPI Number | 1588750533
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF HEALTH AND HOSPITALS
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 10/24/2013
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Provider Practice Location Address
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Address Line | 312 COURT ST
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City | VILLE PLATTE
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State | LA
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Zip | 70586-5248
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Country | US
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Telephone | 337-363-5525
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Fax | 337-363-1567
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Provider Business Mailing Address
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Address Line | 312 SOUTH COURT ST.
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City | VILLE PLATTE
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State | LA
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Zip | 70586
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Country | US
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Telephone | 337-363-5525
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Fax | 337-363-1567
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Authorized Official
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Title or Position | MENTAL HEALTH CENTER MANAGER
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Name | MRS. NANCY F. BOURQUE
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Credential | LCSW
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Telephone | 337-363-5526
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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 | 111
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License Number State | LA
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