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Organization
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Active
Organization
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Active
Other names
Tallulah Behavioral Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIA GREEN (ADMINSITRATIVE PROGRAM SPECIALIST B)
(318) 362-3270
Entity
Organization
Contact information
Practice address
1012 JOHNSON ST, TALLULAH, LA 71282-5216
(318) 574-1713
(381) 574-2299
Mailing address
1012 JOHNSON ST, TALLULAH, LA 71282-5216
(318) 574-1713
(381) 574-2299
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2203782765
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710351
—
LA
Enumeration date
07/22/2013
Last updated
10/06/2023
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