Provider Demographics
NPI:1356384333
Name:OUTREACH BEHAVIORAL HEALTH SOLUTIONS
Entity type:Organization
Organization Name:OUTREACH BEHAVIORAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:W
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:225-667-2792
Mailing Address - Street 1:1810 FLORIDA BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-4951
Mailing Address - Country:US
Mailing Address - Phone:225-791-4552
Mailing Address - Fax:225-791-4552
Practice Address - Street 1:1810 FLORIDA BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4951
Practice Address - Country:US
Practice Address - Phone:225-791-4552
Practice Address - Fax:225-791-4552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPENDING101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty