1790835544 NPI number — PERSONAL SOLUTIONS, INC.

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 1790835544 NPI number — PERSONAL SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERSONAL SOLUTIONS, INC.
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:
LOUISIANA CRITICAL INCIDENT STRESS MANAGEMENT
Provider Other Organization Name Type Code:
4
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:
1790835544
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8873 QUIMPER PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHREVEPORT
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71105-5620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-686-0012
Provider Business Mailing Address Fax Number:
318-686-0012

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8873 QUIMPER PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71105-5620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-686-0012
Provider Business Practice Location Address Fax Number:
318-686-0012
Provider Enumeration Date:
01/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TUBERVILLE
Authorized Official First Name:
J.
Authorized Official Middle Name:
DURELL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
318-686-0012

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  MFT482 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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