Organization
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Active
Parent organization
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Other names
Bastrop Behavioral Health Clinic
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
451 E MADISON AVE, BASTROP, LA 71220-3829
(318) 283-0868
(318) 283-0875
Mailing address
451 E MADISON AVE, BASTROP, LA 71220-3829
(318) 283-0868
(318) 283-0875
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2203782906
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750051
—
LA
Enumeration date
07/24/2013
Last updated
10/06/2023
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