Provider Demographics
NPI:1154402618
Name:DEPARTMENT OF HEALTH & HOSPITALS
Entity type:Organization
Organization Name:DEPARTMENT OF HEALTH & HOSPITALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OAD REGIONAL ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:318-362-3270
Mailing Address - Street 1:5159 HIGHWAY 4 E
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-3581
Mailing Address - Country:US
Mailing Address - Phone:318-362-3270
Mailing Address - Fax:318-362-3268
Practice Address - Street 1:5159 HIGHWAY 4 E
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3581
Practice Address - Country:US
Practice Address - Phone:318-362-3270
Practice Address - Fax:318-362-3268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALCSW 45371041C0700X
LALCSW97591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAH6210OtherBCBS
LAH6210OtherBCBS