Organization
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Active
Parent organization
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Other names
Tallulah 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 SPECIALIST B)
(318) 362-3270
Entity
Organization
Contact information
Practice address
1012 JOHNSON ST, TALLULAH, LA 71282-5216
(318) 574-1713
(318) 574-2299
Mailing address
1012 JOHNSON ST, TALLULAH, LA 71282-5216
(318) 574-1713
(318) 574-2299
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
08/30/2023
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