# DELTA BEHAVIORAL HEALTH SERVICES

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

## Provider details

- **NPI number:** 1609566967
- **Authorized official:** ASHLEY BROCK (DIRECTOR OF REVENUE)
- **Authorized official phone:** (318) 281-2448

## Contact information

- **Practice address:** 4673 EUGENE WARE BLVD, BASTROP, LA 71220-1425
- **Practice address phone:** (318) 281-2448
- **Practice address fax:** (866) 819-6912
- **Mailing address:** 414 PINE ST, MONROE, LA 71201-6228
- **Mailing address phone:** (318) 281-2448
- **Mailing address fax:** (866) 819-6912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 05/10/2023
- **Last updated:** 05/10/2023