Provider Demographics
NPI:1174080816
Name:ROC WITH KNOWLEDGE & GRIT, INC.
Entity type:Organization
Organization Name:ROC WITH KNOWLEDGE & GRIT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:318-955-8035
Mailing Address - Street 1:259 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:DRY PRONG
Mailing Address - State:LA
Mailing Address - Zip Code:71423-3479
Mailing Address - Country:US
Mailing Address - Phone:318-955-8035
Mailing Address - Fax:
Practice Address - Street 1:259 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:DRY PRONG
Practice Address - State:LA
Practice Address - Zip Code:71423-3479
Practice Address - Country:US
Practice Address - Phone:318-955-8035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty