Organization Name: | LOUISIANA HEALTH & REHABILITATION COPTIONS |
NPI Number: | 1003063199 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SOUNDRA JOHNSON TEMPLE (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 930 Webb St Lafayette |
State: | LA US |
Postal Code: | 705013930 |
Phone Number: | 3372677375 |
Fax Number: | 3372695616 |
NPI Enumeration Date: | 08/20/2008 |
NPI Last Update Date: | 08/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TM1800X |
License Number: | PCA 11826 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Mental Retardation & Developmental Disabilities |
Taxonomy Definition: |