Provider Demographics
NPI:1083002331
Name:TWILIGHT CENTER LLC
Entity Type:Organization
Organization Name:TWILIGHT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CORDEL
Authorized Official - Middle Name:Y
Authorized Official - Last Name:PARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-757-6700
Mailing Address - Street 1:3800 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-3848
Mailing Address - Country:US
Mailing Address - Phone:225-757-6700
Mailing Address - Fax:225-757-6711
Practice Address - Street 1:3800 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-757-6700
Practice Address - Fax:225-757-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1462748Medicaid
LA1336175934OtherNPI NUMBER
LAI17367Medicare UPIN
LA1462748Medicaid