Provider Demographics
NPI:1902264542
Name:WEBSTER PARISH POLICE JURY OFFICE OF COMMUNITY SERVICES
Entity Type:Organization
Organization Name:WEBSTER PARISH POLICE JURY OFFICE OF COMMUNITY SERVICES
Other - Org Name:WEBSTER PARISH COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-377-7022
Mailing Address - Street 1:208 GLEASON ST
Mailing Address - Street 2:P.O. BOX 876
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3454
Mailing Address - Country:US
Mailing Address - Phone:318-377-7088
Mailing Address - Fax:318-377-2870
Practice Address - Street 1:208 GLEASON ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3454
Practice Address - Country:US
Practice Address - Phone:318-377-7088
Practice Address - Fax:318-377-2870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1185353Medicare PIN