Basic Information
Provider Information
NPI: 1164888293
EntityType: 2
ReplacementNPI:  
OrganizationName: LOUISIANA UNITED METHODIST CHILDREN & FAMILY SERVICES, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: METHODIST FOSTER CARE MONROE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 904 DEVILLE LANE
Address2:  
City: RUSTON
State: LA
PostalCode: 71270
CountryCode: US
TelephoneNumber: 3182555020
FaxNumber: 3182556623
Practice Location
Address1: 3101 ARMAND ST STE 3
Address2:  
City: MONROE
State: LA
PostalCode: 712013940
CountryCode: US
TelephoneNumber: 3186802550
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/05/2016
LastUpdateDate: 06/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WHEAT
AuthorizedOfficialFirstName: RICK
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT/CEO
AuthorizedOfficialTelephone: 3182555020
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
253J00000X  Y AgenciesFoster Care Agency 

No ID Information.


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