Provider Demographics
NPI:1013134543
Name:BETHESDA COMMUNITY PROGRAMS, INC.
Entity type:Organization
Organization Name:BETHESDA COMMUNITY PROGRAMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUEEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:NARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-263-2947
Mailing Address - Street 1:1799 STUMPF BLVD
Mailing Address - Street 2:BLDG 2 STE 6
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-3950
Mailing Address - Country:US
Mailing Address - Phone:504-263-2947
Mailing Address - Fax:504-263-2940
Practice Address - Street 1:1799 STUMPF BLVD
Practice Address - Street 2:BLDG 2 STE 6
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-3950
Practice Address - Country:US
Practice Address - Phone:504-263-2947
Practice Address - Fax:504-263-2940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1135151Medicaid
LA1536644Medicaid
LA1098884Medicaid
LA1536636Medicaid
LA1453749Medicaid
LA1129381Medicaid
LA1175846Medicaid
LA1453650Medicaid
LA1462110Medicaid
LA1098892Medicaid
LA1110639Medicaid