Provider Demographics
NPI:1376192484
Name:DENA CHILDREN CENTER LLC
Entity Type:Organization
Organization Name:DENA CHILDREN CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GABOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-616-1074
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70429-0159
Mailing Address - Country:US
Mailing Address - Phone:410-616-1074
Mailing Address - Fax:985-241-0990
Practice Address - Street 1:1640 S COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-5800
Practice Address - Country:US
Practice Address - Phone:410-616-1074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility