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Organization

INNOVATIVE COMMUNITY ACTION NETWORK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHRISTOPHER DEWAYNE HANDY PHD (EXECUTIVE DIRECTOR)
(318) 280-6110
Entity
Organization

Contact information

Practice address
1108 DELLWOOD DR STE A, RICHWOOD, LA 71202-6738
(318) 280-6110
Mailing address
PO BOX 7514, MONROE, LA 71211-7514
(318) 280-6110

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
251B00000X
Case Management Agency
Primary
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
12/06/2011
Last updated
12/06/2011
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