Provider Demographics
NPI:1760838635
Name:COMPLETE CARE SERVICES 2
Entity Type:Organization
Organization Name:COMPLETE CARE SERVICES 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DERXANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-252-6241
Mailing Address - Street 1:140 ASPEN SQ
Mailing Address - Street 2:SUITE B
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-5323
Mailing Address - Country:US
Mailing Address - Phone:225-252-6241
Mailing Address - Fax:
Practice Address - Street 1:140 ASPEN SQ
Practice Address - Street 2:SUITE B
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-5323
Practice Address - Country:US
Practice Address - Phone:225-252-6241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0000000Medicaid