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General NPI Number Information
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NPI Number | 1831062983
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Entity Type | Organization
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Legal Business Name | BOGUE CHITTO HEIGHTS BAPTIST CHURCH, INC
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 400 MEMPHIS ST
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City | BOGALUSA
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State | LA
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Zip | 70427-3862
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Country | US
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Telephone | 985-241-7613
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Fax |
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Provider Business Mailing Address
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Address Line | 400 MEMPHIS ST
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City | BOGALUSA
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State | LA
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Zip | 70427-3862
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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 | PRESIDENT
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Name | TOM GRAVES
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Credential |
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Telephone | 985-960-4113
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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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