Provider Demographics
NPI:1285826586
Name:THEOPHILUS COMMUNITY PROGRAMS, INC.
Entity Type:Organization
Organization Name:THEOPHILUS COMMUNITY PROGRAMS, INC.
Other - Org Name:TCP, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, GSW
Authorized Official - Phone:225-928-1730
Mailing Address - Street 1:PO BOX 2900
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70054-2900
Mailing Address - Country:US
Mailing Address - Phone:225-928-1730
Mailing Address - Fax:225-928-1824
Practice Address - Street 1:1000 N MORRISON BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-2233
Practice Address - Country:US
Practice Address - Phone:985-429-1002
Practice Address - Fax:985-429-1448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7412251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA7412Medicaid