| Louisiana Statewide Family Support Organization | |
|
1112 5th St Gretna LA 70053-6008 | |
| (504) 858-4673 | |
| (855) 662-4366 |
| Full Name | Louisiana Statewide Family Support Organization |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1112 5th St, Gretna, Louisiana |
| Authorized Official Name and Position | Darrin Leon Harris (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5048584673 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisiana Statewide Family Support Organization 1112 5th St Gretna LA 70053-6008 Ph: (504) 267-0470 | Louisiana Statewide Family Support Organization 1112 5th St Gretna LA 70053-6008 Ph: (504) 858-4673 |
| NPI Number | 1659636561 |
|---|---|
| Provider Enumeration Date | 07/06/2012 |
| Last Update Date | 11/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659636561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 385HR2055X | Respite Care - Respite Care, Mental Illness, Child | (Louisiana) | Secondary |
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