Organization
NORTHEAST DELTA HUMAN SERVICES AUTHORITY
Active
Other names
Tallulah Behavioral Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIA GREEN (ADMINSITRATIVE PROGRAM SPECIALIST B)
(318) 362-3270
Entity
Organization
Contact information
Practice address
1012 JOHNSON ST, TALLULAH, LA 71282-5216
(318) 574-1713
(381) 574-2299
Mailing address
1012 JOHNSON ST, TALLULAH, LA 71282-5216
(318) 574-1713
(381) 574-2299
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2203782765
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710351
—
LA
Enumeration date
07/22/2013
Last updated
10/06/2023
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