Provider Demographics
NPI:1669617775
Name:HUMAN SERVICE MANAGEMENT AND INVESTMENT LLC
Entity type:Organization
Organization Name:HUMAN SERVICE MANAGEMENT AND INVESTMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA-HUMAN DEVELOPMENT
Authorized Official - Phone:985-223-2429
Mailing Address - Street 1:7224 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2852
Mailing Address - Country:US
Mailing Address - Phone:985-223-2429
Mailing Address - Fax:985-223-2431
Practice Address - Street 1:7224 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2852
Practice Address - Country:US
Practice Address - Phone:985-223-2429
Practice Address - Fax:985-223-2431
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMAN SERVICE MANAGEMENT ANND INVESTMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11179103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1093990749Medicaid
LA1336315936Medicaid
LA1982727558Medicaid
LA1770768319Medicaid
LA1144403353Medicaid
LA1457474025Medicaid
LA18413118859Medicaid