Provider Demographics
NPI:1235330598
Name:FRANKLINTON ASSOCAITION FOR CHALLENGED CITIZENS, INC.
Entity Type:Organization
Organization Name:FRANKLINTON ASSOCAITION FOR CHALLENGED CITIZENS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CREEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-839-6688
Mailing Address - Street 1:PO BOX 622
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438-0622
Mailing Address - Country:US
Mailing Address - Phone:985-839-5891
Mailing Address - Fax:985-839-5897
Practice Address - Street 1:2008 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-3620
Practice Address - Country:US
Practice Address - Phone:985-839-5891
Practice Address - Fax:985-839-5897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1190225251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1190225Medicaid