Provider Demographics
NPI:1518702182
Name:CADDO PARISH SHERIFF'S OFFICE
Entity type:Organization
Organization Name:CADDO PARISH SHERIFF'S OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:KELLI HAYES, RN
Authorized Official - Phone:318-677-5270
Mailing Address - Street 1:501 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-5401
Mailing Address - Country:US
Mailing Address - Phone:318-677-5254
Mailing Address - Fax:318-677-5293
Practice Address - Street 1:1101 FORUM DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-6337
Practice Address - Country:US
Practice Address - Phone:318-677-5254
Practice Address - Fax:318-677-5293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health