Provider Demographics
NPI:1477679181
Name:OUACHITA PARISH SCHOOL BOARD
Entity Type:Organization
Organization Name:OUACHITA PARISH SCHOOL BOARD
Other - Org Name:RISER SHOOL BASED HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF SCHOOL BASED HLTH CLNC
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-325-0973
Mailing Address - Street 1:100 PRICE DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-6315
Mailing Address - Country:US
Mailing Address - Phone:318-325-0973
Mailing Address - Fax:318-361-9323
Practice Address - Street 1:100 PRICE DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71292-6315
Practice Address - Country:US
Practice Address - Phone:318-325-0973
Practice Address - Fax:318-361-9323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008723261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1446181Medicaid
LA1446181Medicaid