Provider Demographics
NPI:1912067232
Name:OPH LSU HEALTH SCIENCES REGION 6
Entity Type:Organization
Organization Name:OPH LSU HEALTH SCIENCES REGION 6
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NFP SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILGER
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:318-483-7181
Mailing Address - Street 1:2351 VANDENBURG DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-5609
Mailing Address - Country:US
Mailing Address - Phone:318-483-7181
Mailing Address - Fax:318-483-7179
Practice Address - Street 1:2351 VANDENBURG DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-5609
Practice Address - Country:US
Practice Address - Phone:318-483-7181
Practice Address - Fax:318-483-7179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACM 1717251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1469114Medicaid