Provider Demographics
NPI:1093376527
Name:BATON ROUGE BLACK ALCOHOLISM COUNCIL
Entity Type:Organization
Organization Name:BATON ROUGE BLACK ALCOHOLISM COUNCIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-338-9333
Mailing Address - Street 1:950 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-6622
Mailing Address - Country:US
Mailing Address - Phone:225-338-9333
Mailing Address - Fax:
Practice Address - Street 1:950 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-6622
Practice Address - Country:US
Practice Address - Phone:225-338-9333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BATON ROUGE BLACK ALCOHOLISM COUNCIL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty