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Organization

CHITIMACHA TRIBE OF LOUISIANA

Active
Parent organization
CHITIMACHA TRIBE OF LOUISIANA
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHITIMACHA TRIBE OF LOUISIANA
Authorized official
MS. TRICIA LYNN MORA (DIRECTOR HEALTH AND HUMAN SERVICES)
(337) 923-9955
Entity
Organization

Contact information

Practice address
3231 CHITIMACHA TRAIL, CHARENTON, LA 70523-0661
(337) 923-9955
(337) 923-6848
Mailing address
PO BOX 640, CHARENTON, LA 70523-0640
(337) 923-9955
(337) 923-6848

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
15134R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1233978
LA
Enumeration date
01/26/2007
Last updated
06/20/2013
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