Provider Demographics
NPI:1497020739
Name:CHILDREN'S COALITION FOR NORTHEAST LOUISIANA
Entity Type:Organization
Organization Name:CHILDREN'S COALITION FOR NORTHEAST LOUISIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, FAMILY SUPPORT ORG
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCGREW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-323-8775
Mailing Address - Street 1:1363 LOUISVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-6021
Mailing Address - Country:US
Mailing Address - Phone:318-323-8775
Mailing Address - Fax:318-323-1150
Practice Address - Street 1:1363 LOUISVILLE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6021
Practice Address - Country:US
Practice Address - Phone:318-323-8775
Practice Address - Fax:318-323-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health