Provider Demographics
NPI:1811261365
Name:PROJECT CELEBRATION, INC.
Entity type:Organization
Organization Name:PROJECT CELEBRATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:318-256-6242
Mailing Address - Street 1:580 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANY
Mailing Address - State:LA
Mailing Address - Zip Code:71449-3005
Mailing Address - Country:US
Mailing Address - Phone:318-256-6242
Mailing Address - Fax:318-256-2064
Practice Address - Street 1:580 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANY
Practice Address - State:LA
Practice Address - Zip Code:71449-3005
Practice Address - Country:US
Practice Address - Phone:318-256-6242
Practice Address - Fax:318-256-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========OtherEIN