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General NPI Number Information
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NPI Number | 1811225527
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Entity Type | Organization
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Legal Business Name | ETERNAL CRISIS OUTREACH
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 03/03/2017
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Provider Practice Location Address
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Address Line | 5759 WRIGHT DR
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City | BATON ROUGE
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State | LA
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Zip | 70812-2355
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Country | US
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Telephone | 225-326-9166
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Fax | 225-354-8334
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Provider Business Mailing Address
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Address Line | 5759 WRIGHT DR
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City | BATON ROUGE
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State | LA
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Zip | 70812-2355
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Country | US
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Telephone | 225-387-8240
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Fax | 225-387-8241
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. RENETTA A BELL
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Credential | LAC
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Telephone | 225-326-9166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | CM 27018
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License Number State | LA
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Taxonomy #2
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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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