# GRAMBLING STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043648173
- **Authorized official:** MRS. PATRICE OUTLEY N.P. (DIRECTOR OF STUDENT HEALTH SERVICES)
- **Authorized official phone:** (318) 274-2351

## Contact information

- **Practice address:** 403 MAIN ST, GRAMBLING, LA 71245-2715
- **Practice address phone:** (318) 274-2351
- **Mailing address:** 403 MAIN ST, P.O. BOX 4251, GRAMBLING, LA 71245-2715
- **Mailing address phone:** (318) 274-2351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/29/2013
- **Last updated:** 10/29/2013