Provider Demographics
NPI:1508280298
Name:LOUISIANA CASE MANAGEMENT NORTHWEST,LLC
Entity Type:Organization
Organization Name:LOUISIANA CASE MANAGEMENT NORTHWEST,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:LANPHIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-928-8989
Mailing Address - Street 1:8352 BLUEBONNET BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2825
Mailing Address - Country:US
Mailing Address - Phone:225-928-8989
Mailing Address - Fax:122-592-8990
Practice Address - Street 1:8352 BLUEBONNET BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LOUISIANA
Practice Address - Zip Code:70810
Practice Address - Country:UM
Practice Address - Phone:1225-928-8989
Practice Address - Fax:1225-928-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization