Provider Demographics
NPI:1265611883
Name:HEALTH ENRICHMENT NETWORK
Entity type:Organization
Organization Name:HEALTH ENRICHMENT NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:H
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-335-2112
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463-0566
Mailing Address - Country:US
Mailing Address - Phone:318-335-2112
Mailing Address - Fax:318-215-0613
Practice Address - Street 1:713 E 7TH AVE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-2724
Practice Address - Country:US
Practice Address - Phone:318-335-2112
Practice Address - Fax:318-215-0613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
5CJ64Medicare PIN