Organization
POSITIVE FAMILY SUPPORT SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E MIZELL (OWNER)
(985) 516-5604
Entity
Organization
Contact information
Practice address
748 AVENUE F, BOGALUSA, LA 70427-3656
(985) 241-5100
(985) 241-5337
Mailing address
748 AVENUE F, BOGALUSA, LA 70427-3656
(985) 241-5100
(985) 241-5337
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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