Organization
IHSC @ LASALLE DETENTION FACILITY
Active
Other names
STG INTERNATIONAL
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER BALLARD RN, BSN (CDR)
(318) 992-7612
Entity
Organization
Contact information
Practice address
830 PINEHILL RD, JENA, LA 71342-4137
(318) 992-7613
Mailing address
830 PINEHILL RD, JENA, LA 71342-4137
(318) 992-7613
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06993
LA
Other
Enumeration date
03/07/2013
Last updated
03/08/2013
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