Provider Demographics
NPI:1124298542
Name:BEHAVIORAL HEALTH CENTER
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHAETRA
Authorized Official - Middle Name:KAFUNYA
Authorized Official - Last Name:RANEY-SEMIEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:318-335-3390
Mailing Address - Street 1:119 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463-2742
Mailing Address - Country:US
Mailing Address - Phone:318-335-3390
Mailing Address - Fax:318-335-2907
Practice Address - Street 1:119 N 13TH ST
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-2742
Practice Address - Country:US
Practice Address - Phone:318-335-3390
Practice Address - Fax:318-335-2907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1178161343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)