Provider Demographics
NPI:1902167331
Name:HUMAN SERVICES FOUNDATION, INC.
Entity Type:Organization
Organization Name:HUMAN SERVICES FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:MALONE
Authorized Official - Last Name:SUMERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:225-344-1600
Mailing Address - Street 1:1410 CONVENTION ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-4778
Mailing Address - Country:US
Mailing Address - Phone:225-344-1600
Mailing Address - Fax:225-344-1694
Practice Address - Street 1:1410 CONVENTION ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-4778
Practice Address - Country:US
Practice Address - Phone:225-344-1600
Practice Address - Fax:225-344-1694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-01
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA318101YA0400X
LA101YA0400X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA600793890Medicaid