1194219048 NPI number — YOUTH AND FAMILY OUTREACH SERVICES NORTH LOUISIANA

Table of content: (NPI 1194219048)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194219048 NPI number — YOUTH AND FAMILY OUTREACH SERVICES NORTH LOUISIANA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOUTH AND FAMILY OUTREACH SERVICES NORTH LOUISIANA
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:
Provider Other Organization Name Type Code:
6
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:
1194219048
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7509 GOLDEN MEADOWS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWOOD
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-780-2452
Provider Business Mailing Address Fax Number:
888-400-9758

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6007 FINANCIAL PLZ
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:
71129-2655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-545-4488
Provider Business Practice Location Address Fax Number:
888-400-9758
Provider Enumeration Date:
06/14/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MCGEE
Authorized Official First Name:
YOLUNDA
Authorized Official Middle Name:
EVETTE
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
318-780-2452

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 826953221 . This is a "CASE MANAGEMENT" identifier . This identifiers is of the category "OTHER".




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