Provider Demographics
NPI:1750514113
Name:LA HEALTH CENTERS, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:LA HEALTH CENTERS, A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHIE
Authorized Official - Middle Name:REED
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:225-664-1456
Mailing Address - Street 1:32350 LA HIGHWAY 16
Mailing Address - Street 2:BLDG C
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-1463
Mailing Address - Country:US
Mailing Address - Phone:225-664-1456
Mailing Address - Fax:
Practice Address - Street 1:32350 LA HIGHWAY 16
Practice Address - Street 2:BLDG C
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-1463
Practice Address - Country:US
Practice Address - Phone:225-664-1456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04489R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty