Provider Demographics
NPI:1407247778
Name:COUSHATTA TRIBE OF LOUISIANA
Entity Type:Organization
Organization Name:COUSHATTA TRIBE OF LOUISIANA
Other - Org Name:COUSHATTA HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, DO
Authorized Official - Phone:337-584-1650
Mailing Address - Street 1:2007 CC BEL RD
Mailing Address - Street 2:
Mailing Address - City:ELTON
Mailing Address - State:LA
Mailing Address - Zip Code:70532
Mailing Address - Country:US
Mailing Address - Phone:337-584-1650
Mailing Address - Fax:337-584-1653
Practice Address - Street 1:2007 CC BEL RD
Practice Address - Street 2:
Practice Address - City:ELTON
Practice Address - State:LA
Practice Address - Zip Code:70532
Practice Address - Country:US
Practice Address - Phone:337-584-1650
Practice Address - Fax:337-584-1653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care