Organization
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Active
Parent organization
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Other names
Bastrop Behavioral Health Clinic - Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Authorized official
OCTAVIA GREEN (ADMINISTRATIVE PROGRAM MANAGER)
(318) 362-3270
Entity
Organization
Contact information
Practice address
451 E MADISON AVE, BASTROP, LA 71220-3829
(318) 283-0868
(318) 556-7090
Mailing address
450 E PINE STREET, BASTROP, LA 71220-3840
(318) 283-0868
(318) 283-0875
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
02/09/2022
Last updated
06/04/2025
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