Organization
HEALTH PARADIGM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISA M VANDENBERG (ADMINISTRATOR)
(318) 251-2322
Entity
Organization
Contact information
Practice address
615 S TRENTON ST, RUSTON, LA 71270-5040
(318) 251-2322
(318) 251-0710
Mailing address
615 S TRENTON ST, RUSTON, LA 71270-5040
(318) 251-2322
(318) 251-0710
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CI 3505 LA
LA
2084P0800X
Psychiatry Physician
Primary
1164R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1681032
—
LA
Enumeration date
05/25/2007
Last updated
09/01/2010
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