Provider Demographics
NPI:1790886588
Name:COMPREHENSIVE MENTAL HEALTH CENTER OF BATON ROUGE, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE MENTAL HEALTH CENTER OF BATON ROUGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-785-8003
Mailing Address - Street 1:5550 THOMAS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70811-7354
Mailing Address - Country:US
Mailing Address - Phone:225-778-1100
Mailing Address - Fax:225-778-1199
Practice Address - Street 1:5550 THOMAS RD
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70811-7354
Practice Address - Country:US
Practice Address - Phone:225-778-1100
Practice Address - Fax:225-778-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA60105OtherBCBS
LA60105OtherBCBS