Trinity Behavioral Health of Port Allen

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

TRINITY BEHAVIORAL HEALTH OF PORT ALLEN

Practice address

2753 Court Street
Unit C
Port Allen, LA 70767

Phone

(225) 389-5837

Fax

(225) 389-5836

NPI assigned

Sep 18, 2007

Last updated

Nov 3, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Troy Wyatt Edmond

Title

Director of Operations

Phone

(225) 389-5837

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225670400000",
    "number": "1518153139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2753 COURT STREET",
            "address_2": "UNIT C & D",
            "city": "PORT ALLEN",
            "state": "LA",
            "postal_code": "707672509",
            "telephone_number": "225-389-5837",
            "fax_number": "225-389-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2753 COURT STREET",
            "address_2": "UNIT C",
            "city": "PORT ALLEN",
            "state": "LA",
            "postal_code": "70767",
            "telephone_number": "225-389-5837",
            "fax_number": "225-389-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY BEHAVIORAL HEALTH OF PORT ALLEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2008-11-03",
        "status": "A",
        "authorized_official_last_name": "EDMOND",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "WYATT",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "225-389-5837",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Port Allen, LA
• Providers in Port Allen, LA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.