Provider Demographics
NPI:1568524403
Name:OPH-REGION 3-NURSE FAMILY PARTNERSHIP
Entity Type:Organization
Organization Name:OPH-REGION 3-NURSE FAMILY PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:R-3 NFP SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LUWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:985-632-5567
Mailing Address - Street 1:600 POLK ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4154
Mailing Address - Country:US
Mailing Address - Phone:985-857-3602
Mailing Address - Fax:985-857-3007
Practice Address - Street 1:600 POLK ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4154
Practice Address - Country:US
Practice Address - Phone:985-857-3602
Practice Address - Fax:985-857-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACM 9914251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1567116Medicaid