Provider Demographics
NPI:1861696577
Name:JEFFERSON OAKS BEHAVIORAL HEALTH INC
Entity type:Organization
Organization Name:JEFFERSON OAKS BEHAVIORAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOUB
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:225-927-5624
Mailing Address - Street 1:8318 JEFFERSON HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1624
Mailing Address - Country:US
Mailing Address - Phone:225-927-5624
Mailing Address - Fax:225-927-5611
Practice Address - Street 1:8318 JEFFERSON HWY
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1624
Practice Address - Country:US
Practice Address - Phone:225-927-5624
Practice Address - Fax:225-927-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health