Provider Demographics
NPI:1639473606
Name:NORTH DELTA HUMAN SERVICE AUTHORITY
Entity Type:Organization
Organization Name:NORTH DELTA HUMAN SERVICE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-331-6952
Mailing Address - Street 1:2513 FERRAND ST STE A
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3210
Mailing Address - Country:US
Mailing Address - Phone:318-331-6952
Mailing Address - Fax:
Practice Address - Street 1:2513 FERRAND ST STE A
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3210
Practice Address - Country:US
Practice Address - Phone:318-331-6952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health