Provider Demographics
NPI:1629529292
Name:VOLUNTEERS OF AMERICA NORTH LOUISIANA
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA NORTH LOUISIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF BEHAVIOR
Authorized Official - Prefix:
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:318-221-8404
Mailing Address - Street 1:520 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-2312
Mailing Address - Country:US
Mailing Address - Phone:318-221-8404
Mailing Address - Fax:318-227-6179
Practice Address - Street 1:520 OLIVE ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-2312
Practice Address - Country:US
Practice Address - Phone:318-221-8404
Practice Address - Fax:318-227-6179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health