1699097907 NPI number — HEALTH CARE CENTERS IN SCHOOLS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699097907 NPI number — HEALTH CARE CENTERS IN SCHOOLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH CARE CENTERS IN SCHOOLS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HCS-BROADMOOR HIGH SCHOOL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699097907
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 64749
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70896-4749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-343-9505
Provider Business Mailing Address Fax Number:
225-343-9141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10100 GOODWOOD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70815-4521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-343-9505
Provider Business Practice Location Address Fax Number:
225-343-9141
Provider Enumeration Date:
02/28/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LIVELY
Authorized Official First Name:
JULIA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
225-343-9505

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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