Provider Demographics
NPI:1801106638
Name:DHH OFFICE OF BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:DHH OFFICE OF BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN3
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:RICKS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:318-283-0817
Mailing Address - Street 1:218 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-3818
Mailing Address - Country:US
Mailing Address - Phone:318-283-0817
Mailing Address - Fax:
Practice Address - Street 1:218 NORTH FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220
Practice Address - Country:US
Practice Address - Phone:318-283-0817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGION 8 COMMUNITY MENTAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health