1578826137 NPI number — CANE RIVER CHILDREN'S SERVICES, INC.

Table of content: LAUREN JILL TOSTRUD MD (NPI 1609564897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578826137 NPI number — CANE RIVER CHILDREN'S SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CANE RIVER CHILDREN'S SERVICES, 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:
Provider Other Organization Name Type Code:
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:
1578826137
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2453
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATCHITOCHES
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71457-2453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-352-9349
Provider Business Mailing Address Fax Number:
318-352-9345

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 RUE DEGABRIEL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATCHITOCHES
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-352-9349
Provider Business Practice Location Address Fax Number:
318-352-9345
Provider Enumeration Date:
06/19/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KARLE
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
318-352-9349

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253J00000X , with the licence number: 13372 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X , with the licence number: 6318 , 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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