Provider Demographics
NPI:1356420558
Name:HELIOS OUTPATIENT CENTER, L.L.C.
Entity type:Organization
Organization Name:HELIOS OUTPATIENT CENTER, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:LEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-649-5825
Mailing Address - Street 1:1850 GAUSE BLVD E
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5442
Mailing Address - Country:US
Mailing Address - Phone:985-649-5825
Mailing Address - Fax:985-645-0884
Practice Address - Street 1:1850 GAUSE BLVD E
Practice Address - Street 2:SUITE 201
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5442
Practice Address - Country:US
Practice Address - Phone:985-649-5825
Practice Address - Fax:985-645-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA119261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA190020233ZOtherBLUE CROSS BLUE SHIELD LA
LA173801000OtherWORKERS COMP
LA173801000OtherWORKERS COMP