Provider Demographics
NPI:1255485967
Name:DEPARTMENT OF HEALTH AND HOSPITALS
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH AND HOSPITALS
Other - Org Name:BOGALUSA MENTAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FACILITY MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-732-6610
Mailing Address - Street 1:619 WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-3001
Mailing Address - Country:US
Mailing Address - Phone:985-732-6610
Mailing Address - Fax:985-732-6626
Practice Address - Street 1:619 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3001
Practice Address - Country:US
Practice Address - Phone:985-732-6610
Practice Address - Fax:985-732-6626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA131261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1710091Medicaid
LA5B212Medicare ID - Type Unspecified