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General NPI Number Information
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NPI Number | 1982973442
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Entity Type | Organization
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Legal Business Name | OGLETHORP OF BATON ROUGE LLC
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 4040 NORTH BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70806-3829
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Country | US
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Telephone | 813-978-1933
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Fax |
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Provider Business Mailing Address
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Address Line | 7074 GROVE RD
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City | BROOKSVILLE
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State | FL
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Zip | 34609-8658
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Country | US
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Telephone | 813-978-1933
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Fax | 352-610-9996
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Authorized Official
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Title or Position | DIRECTOR REVENUE CYCLE MANAGEMENT
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Name | TRACY ROBERTS
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Credential |
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Telephone | 423-895-0084
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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 | 709
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License Number State | LA
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