Provider Demographics
NPI:1427195460
Name:DEPARTMENT OF HEALTH & HOSPITALS
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH & HOSPITALS
Other - Org Name:MANSFIELD BEHAVIORAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR. OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-676-5160
Mailing Address - Street 1:501 LOUISIANA AVENUE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71052-2621
Mailing Address - Country:US
Mailing Address - Phone:318-872-5576
Mailing Address - Fax:318-872-9780
Practice Address - Street 1:501 LOUISIANA AVENUE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:LA
Practice Address - Zip Code:71052-2621
Practice Address - Country:US
Practice Address - Phone:318-872-5576
Practice Address - Fax:318-872-9780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA93261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1710113Medicaid
LA5F812Medicare PIN