Provider Type Icon

NORTHEAST DELTA HUMAN SERVICES AUTHORITY NPI 1124772009


NPI Information

NPI: 1124772009
Provider Name: NORTHEAST DELTA HUMAN SERVICES AUTHORITY

Doing Business As: MONROE BEHAVIORAL HEALTH CLINIC-MEDICAL

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 19D1074431

Address:
4800 S GRAND ST
MONROE, LA
ZIP 71202
Phone: (318) 362-3339
Get Directions

NORTHEAST DELTA HUMAN SERVICES AUTHORITY is a primary care clinic center in Monroe, LA. NORTHEAST DELTA HUMAN SERVICES AUTHORITY NPI is 1124772009. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Monroe Behavioral Health Clinic-medical.

The provider's business location address is:

4800 S GRAND ST
MONROE, LA
ZIP 71202-412
Phone: (318) 362-3339
Fax: (318) 362-3336

The provider's authorized official is Octavia Green .
The authorized official title is Administrative Program Specialist B and has the following contact phone number (318) 362-3270.

The CLIA number assigned to this NPI record is 19D1074431 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/9/2022 and was last updated on 8/30/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyNo
2261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.