Basic Information
| Provider Information | |||||||||
| NPI: | 1326464637 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPITAL AREA HUMAN SERVICES DISTRICT SCHOOL BASED SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 66558 | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708966558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2259222700 | ||||||||
| FaxNumber: | 2253625319 | ||||||||
| Practice Location | |||||||||
| Address1: | 2751 WOODDALE BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708057567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2259220478 | ||||||||
| FaxNumber: | 2259222658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2014 | ||||||||
| LastUpdateDate: | 11/17/2021 | ||||||||
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| AuthorizedOfficialLastName: | LAUGHINGHOUSE | ||||||||
| AuthorizedOfficialFirstName: | JANZLEAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2259222700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CAPITAL AREA HUMAN SERVICES DISTRICT | ||||||||
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| AuthorizedOfficialCredential: | PHD, LCSW-BACS, LAC | ||||||||
| NPICertificationDate: | 11/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | N | Agencies | Community/Behavioral Health | 261QM0855X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No ID Information.