Basic Information
| Provider Information | |||||||||
| NPI: | 1841300225 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RESOURCE MANAGEMENT SERVICES, INC. OF SOUTHWEST LOUISIANA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RESOURCE MANAGEMENT SERVICES, INC. OF SWLA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1333 COMMON ST | ||||||||
| Address2: | |||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706015255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374374014 | ||||||||
| FaxNumber: | 3374378283 | ||||||||
| Practice Location | |||||||||
| Address1: | 1333 COMMON ST | ||||||||
| Address2: | |||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706015255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374374014 | ||||||||
| FaxNumber: | 3374378283 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 08/19/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MORGAN | ||||||||
| AuthorizedOfficialFirstName: | TAMMI | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3379905475 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 251S00000X | LA | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 1672335 | 05 | LA | MEDICAID |