Provider Demographics
NPI:1497962765
Name:OUACHITA PARISH SCHOOL BOARD
Entity Type:Organization
Organization Name:OUACHITA PARISH SCHOOL BOARD
Other - Org Name:WEST MONROE SCHOOL BASED HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
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 1:201 RIGGS ST
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-2640
Mailing Address - Country:US
Mailing Address - Phone:318-323-3771
Mailing Address - Fax:
Practice Address - Street 1:201 RIGGS ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-2640
Practice Address - Country:US
Practice Address - Phone:318-323-3771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========OtherPRIVATE INSURANCE TAX ID