Provider Demographics
NPI:1124341425
Name:ALLEN OUTREACH INC.
Entity type:Organization
Organization Name:ALLEN OUTREACH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEJEUNE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, LMFT
Authorized Official - Phone:318-335-3578
Mailing Address - Street 1:113 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463-2742
Mailing Address - Country:US
Mailing Address - Phone:318-335-3578
Mailing Address - Fax:318-335-3753
Practice Address - Street 1:113 N 13TH ST
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-2742
Practice Address - Country:US
Practice Address - Phone:318-335-3578
Practice Address - Fax:318-335-3753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA220251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA250OtherLA DEPARTMENT OF HEALTH & HOSPITALS
LA10885OtherLA ADDICTIVE DISORDERS (LADDS)