Provider Demographics
NPI:1578826137
Name:CANE RIVER CHILDREN'S SERVICES, INC.
Entity Type:Organization
Organization Name:CANE RIVER CHILDREN'S SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KARLE
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:318-352-9349
Mailing Address - Street 1:PO BOX 2453
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-2453
Mailing Address - Country:US
Mailing Address - Phone:318-352-9349
Mailing Address - Fax:318-352-9345
Practice Address - Street 1:425 RUE DEGABRIEL
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457
Practice Address - Country:US
Practice Address - Phone:318-352-9349
Practice Address - Fax:318-352-9345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
LA13372253J00000X
LA6318322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency