Provider Demographics
NPI:1265499958
Name:DEPARTMENT OF HEALTH AND HOSPITAL
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH AND HOSPITAL
Other - Org Name:MINDEN OUTREACH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, CCS
Authorized Official - Phone:318-632-2040
Mailing Address - Street 1:6005 FINANCIAL PLZ
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2615
Mailing Address - Country:US
Mailing Address - Phone:318-632-2040
Mailing Address - Fax:318-632-2073
Practice Address - Street 1:421 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3522
Practice Address - Country:US
Practice Address - Phone:318-632-2040
Practice Address - Fax:318-632-2073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA115261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder