Provider Demographics
NPI:1891467874
Name:O'BRIEN HOUSE
Entity Type:Organization
Organization Name:O'BRIEN HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-855-9023
Mailing Address - Street 1:446 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-4613
Mailing Address - Country:US
Mailing Address - Phone:225-344-6345
Mailing Address - Fax:225-246-7943
Practice Address - Street 1:446 N 12TH ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-4613
Practice Address - Country:US
Practice Address - Phone:225-344-6345
Practice Address - Fax:225-246-7943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty