Provider Demographics
NPI:1972963791
Name:CHILDREN SPECIALITY CENTERS OF AMERICA LLC
Entity type:Organization
Organization Name:CHILDREN SPECIALITY CENTERS OF AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-907-6682
Mailing Address - Street 1:313 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-3001
Mailing Address - Country:US
Mailing Address - Phone:337-907-6682
Mailing Address - Fax:337-907-6685
Practice Address - Street 1:3600 FLORIDA BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3842
Practice Address - Country:US
Practice Address - Phone:337-907-6682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283XC2000XHospitalsRehabilitation HospitalChildren