Provider Demographics
NPI:1841281508
Name:REGIONS COMMUNITY BEHAVIORAL HEALTH CENTER, INC
Entity type:Organization
Organization Name:REGIONS COMMUNITY BEHAVIORAL HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRES & CHIEF OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:225-924-0051
Mailing Address - Street 1:660 N LOBDELL AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-2971
Mailing Address - Country:US
Mailing Address - Phone:225-924-0051
Mailing Address - Fax:225-924-4523
Practice Address - Street 1:4429 SHORES DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2329
Practice Address - Country:US
Practice Address - Phone:504-841-0999
Practice Address - Fax:504-834-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA194677Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER