Provider Demographics
NPI:1437317724
Name:NELLIE BYERS TRAINING CENTER
Entity Type:Organization
Organization Name:NELLIE BYERS TRAINING CENTER
Other - Org Name:QUAZI-PRIVATE ENTITY
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:SCHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-735-5216
Mailing Address - Street 1:640 AVENUE V
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-4456
Mailing Address - Country:US
Mailing Address - Phone:985-735-5216
Mailing Address - Fax:985-735-1923
Practice Address - Street 1:640 AVENUE V
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-4456
Practice Address - Country:US
Practice Address - Phone:985-735-5216
Practice Address - Fax:985-735-1923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10005251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1938165Medicaid