Provider Demographics
NPI:1073789921
Name:HELPING HANDS OF SOUTH LA
Entity Type:Organization
Organization Name:HELPING HANDS OF SOUTH LA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANCI
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MHA,JD
Authorized Official - Phone:337-948-3194
Mailing Address - Street 1:116 E VINE ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-5152
Mailing Address - Country:US
Mailing Address - Phone:337-948-3194
Mailing Address - Fax:337-948-3198
Practice Address - Street 1:116 E VINE ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-5152
Practice Address - Country:US
Practice Address - Phone:337-948-3194
Practice Address - Fax:337-948-3198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1015784302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1015784Medicaid