Organization
HEALTH SERVICESGROUP OF LOUISIANA, LLC
Active
Other names
Gulf States LTAC Washington/St Tammy
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL WALLACE (CFO)
(225) 216-2299
Entity
Organization
Contact information
Practice address
433 PLAZA ST, BOGALUSA, LA 70427-3729
(985) 732-1186
Mailing address
433 PLAZA ST, BOGALUSA, LA 70427-3729
(985) 732-1186
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
418
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60745
BLUE CROSS BLUE SHIELD
LA
Enumeration date
02/02/2006
Last updated
08/22/2020
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