Provider Demographics
NPI:1487707626
Name:DEPARTMENT OF HEALTH & HOSPITAL
Entity type:Organization
Organization Name:DEPARTMENT OF HEALTH & HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH CENTER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JILES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:985-543-4800
Mailing Address - Street 1:15785 MEDICAL ARTS PLAZA
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403
Mailing Address - Country:US
Mailing Address - Phone:985-543-4080
Mailing Address - Fax:985-543-4090
Practice Address - Street 1:15785 MEDICAL ARTS PLAZA
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-543-4080
Practice Address - Fax:985-543-4090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEPARTMENT OF HEALTH & HOSPITALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-19
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA170261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1710164Medicaid
LA1710164Medicaid