Organization
SOUTHEAST LOUISIANA AHEC FOUNDATION, INC
Active
Organization
SOUTHEAST LOUISIANA AHEC FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN PETER JAKES SR. BFA (CHIEF EXECUTIVE OFFICER)
(985) 345-1119
Entity
Organization
Contact information
Practice address
1302 J W DAVIS DR, HAMMOND, LA 70403-5914
(985) 345-1119
Mailing address
1302 J W DAVIS DR, HAMMOND, LA 70403-5914
(985) 345-1119
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
305S00000X
Point of Service
1175790
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117590
—
LA
Enumeration date
03/17/2008
Last updated
03/17/2008
Update your record
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