Provider Demographics
NPI:1275091514
Name:A T.R.U.T.H. 180 HEALTH SERVICES OF LOUISIANA, LLC
Entity Type:Organization
Organization Name:A T.R.U.T.H. 180 HEALTH SERVICES OF LOUISIANA, LLC
Other - Org Name:A TRUTH 180 HEALTH SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-421-4944
Mailing Address - Street 1:1254 CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-3820
Mailing Address - Country:US
Mailing Address - Phone:225-300-4943
Mailing Address - Fax:225-300-4899
Practice Address - Street 1:1254 CENTRAL RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807-3820
Practice Address - Country:US
Practice Address - Phone:225-300-4899
Practice Address - Fax:225-300-4943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty