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General NPI Number Information
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NPI Number | 1821318221
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Entity Type | Organization
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Legal Business Name | BOOKER T COMMUNITY OUTREACH PROJECT
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Dates
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Enumeration Date | 06/08/2010
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 1411 SHERROUSE STREET
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City | MONROE
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State | LA
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Zip | 71203
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Country | US
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Telephone | 318-489-5300
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Fax | 318-934-0097
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Provider Business Mailing Address
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Address Line | 1411 SHERROUSE ST
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City | MONROE
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State | LA
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Zip | 71203-5435
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Country | US
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Telephone | 318-489-5900
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Fax | 318-934-0097
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MS. SHARON DENISE COLLIER
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Credential |
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Telephone | 318-489-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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