Basic Information
| Provider Information | |||||||||
| NPI: | 1407053937 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LOUISIANA UNITED METHODIST CHILDREN & FAMILY SERVICES, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | METHODIST FOSTER CARE RUSTON | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 904 DEVILLE LN | ||||||||
| Address2: | |||||||||
| City: | RUSTON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712706313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182424647 | ||||||||
| FaxNumber: | 3182321272 | ||||||||
| Practice Location | |||||||||
| Address1: | 904 DEVILLE LN | ||||||||
| Address2: | |||||||||
| City: | RUSTON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712706313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182555020 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2007 | ||||||||
| LastUpdateDate: | 06/22/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | YATES | ||||||||
| AuthorizedOfficialFirstName: | JAN | ||||||||
| AuthorizedOfficialMiddleName: | ALEXANDER | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF HEALTH INFORMATION MGT | ||||||||
| AuthorizedOfficialTelephone: | 3182555020 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RHIA | ||||||||
| NPICertificationDate: | 06/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 253J00000X | Y | Agencies | Foster Care Agency |
No ID Information.