Provider Demographics
NPI:1588177646
Name:NHS HUMAN SERVICES
Entity type:Organization
Organization Name:NHS HUMAN SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUBSTANCE ABUSE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BROOKS
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:225-772-9509
Mailing Address - Street 1:13648 CROTWELL RD
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-8815
Mailing Address - Country:US
Mailing Address - Phone:225-615-4740
Mailing Address - Fax:
Practice Address - Street 1:711 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6549
Practice Address - Country:US
Practice Address - Phone:225-246-2162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========0Medicaid