Provider Demographics
NPI:1851505630
Name:HOSPITAL SERVICE DIST. NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LA
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DIST. NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:REEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-785-3643
Mailing Address - Street 1:1057 PAUL MAILLARD RD
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-4349
Mailing Address - Country:US
Mailing Address - Phone:985-785-6242
Mailing Address - Fax:985-785-3642
Practice Address - Street 1:1057 PAUL MAILLARD RD
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-4349
Practice Address - Country:US
Practice Address - Phone:985-785-6242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL SERVICE DIST. NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-10
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA151273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1705322Medicaid
LA190079Medicare Oscar/Certification