| Organization Name: | AMIKIDS NORTHEAS LOUISIANA, INC |
| NPI Number: | 1003107657 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KARVAN TYRONNE POWELL (EXECUTIVE DIRECTOR) |
| Mailing Address: | 1801 Felicia Drive Tallulah |
| State: | LA US |
| Postal Code: | 712840216 |
| Phone Number: | 3185749475 |
| Fax Number: | 3185749478 |
| NPI Enumeration Date: | 04/29/2011 |
| NPI Last Update Date: | 04/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |