Eastern la. Mental Health System Community Homes Division

Organization Active NPI Psychiatric Hospital · Jackson, LA

NPI 1790905545 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1790905545
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric Hospital 283Q00000X
License
697 (LA)
Legal business name
EASTERN LA. MENTAL HEALTH SYSTEM COMMUNITY HOMES DIVISION
Practice address
4502 Hwy. 951
Jackson, LA 70748-0498
Phone
(225) 634-0661
NPI assigned
Apr 26, 2007
Organization subpart
No

Authorized official

Name
Ms. Donna M. Harrell
Title
Adm. Co. 4
Phone
(225) 634-0661

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
East la State Hospital (9 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 697 LA Yes

Addresses

Primary practice location

4502 Hwy. 951
Jackson, LA 70748-0498

Mailing address

PO Box 498
Jackson, LA 70748-0498
Phone (225) 634-0661

Other identifiers

IdentifierTypeStateIssuer
1712299MedicaidLA

Other names

  • W. T. Price Sr., Residence # 99 Other name

Other providers in Jackson, LA

All providers in Jackson, LA · Psychiatric Hospital in Louisiana

Sources for this page

Verify at the official NPI Registry.