Provider Demographics
NPI:1578920088
Name:RESOURCE CENTER
Entity Type:Organization
Organization Name:RESOURCE CENTER
Other - Org Name:THE RESOURCE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAKARA
Authorized Official - Middle Name:NICHELLE
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:225-394-6968
Mailing Address - Street 1:9618 JEFFERSON HWY
Mailing Address - Street 2:STE. D-202
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-9636
Mailing Address - Country:US
Mailing Address - Phone:225-394-6968
Mailing Address - Fax:
Practice Address - Street 1:9618 JEFFERSON HWY
Practice Address - Street 2:STE. D-202
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9636
Practice Address - Country:US
Practice Address - Phone:225-394-6968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA000123074261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health