Organization
EPIPHANY HEALTHCARE SYSTEM, INC
Active
Parent organization
EPIPHANY HEALTHCARE SYSTEM, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EPIPHANY HEALTHCARE SYSTEM, INC
Authorized official
MR. DICKSON OSANU (CEO)
(404) 226-9131
Entity
Organization
Contact information
Practice address
906 C M FAGAN DR BLDG A, SUITE 6A, HAMMOND, LA 70403
(985) 956-7370
(985) 956-7371
Mailing address
906 C M FAGAN DR BLDG A, SUITE 6A, HAMMOND, LA 70403-6056
(985) 956-7370
(985) 956-7371
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/23/2018
Last updated
08/24/2018
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