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Organization

DEPARTMENT OF HEALTH & HOSPITALS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LORI ELIZABETH VIDRINE-PARKS M.D. (STAFF PHYSICIAL)
(337) 363-6869
Entity
Organization

Contact information

Practice address
414 W COTTON ST, VILLE PLATTE, LA 70586-4442
(337) 363-6869
(337) 363-4720
Mailing address
414 W COTTON ST, VILLE PLATTE, LA 70586-4442
(337) 363-6869
(337) 363-4720

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
17683
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1397539
LA
Enumeration date
08/22/2006
Last updated
08/22/2020
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