IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY


Address: 1211 N Cutting Ave, Jennings, LA 70546-4403
Phone: 3372467325

IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY (NPI# 1437522034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437522034
Entity Type Organization
Organization Name IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
Other Organization Name JEFF DAVIS BEHAVIORAL HEALTH CLINIC
Practice Address 1211 N Cutting Ave
Jennings
LA 70546-4403
Practice Telephone 3372467325
Practice Fax Number 3372467328
Mailing Telephone 3372467325
Mailing Fax Number 3372467328
Enumeration Date 2015-11-04
Last Update Date 2015-11-09
Authorized Official Name MS. TANYA MCGEE (EXECUTIVE DIRECTOR)
Authorized Official Telephone 3374753100
Authorized Official Credential LAC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
95-C LA Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Jeff Davis Behavioral Health Clinic Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1457822751 Imperial Calcasieu Human Services Authority Clinic/Center 2651 E Napoleon St, Sulphur, LA 70663 2018-12-12
1598245623 Imperial Calcasieu Human Services Authority Clinic/Center 4105 Kirkman St, Lake Charles, LA 70607-4603 2018-08-17
1467844910 Imperial Calcasieu Human Services Authority Behavioral Analyst 402 Industrial Dr, Oberlin, LA 70655-3519 2015-02-20
1457789802 Imperial Calcasieu Human Services Authority Clinic/Center 3505 5th Ave, Suite C, Lake Charles, LA 70607-2156 2013-10-23
1952449118 Imperial Calcasieu Human Services Authority Family Medicine 4105 Kirkman St, Lake Charles, LA 70607-4603 2007-02-01
1902944184 Imperial Calcasieu Human Services Authority Clinic/Center 106 W Port St, Deridder, LA 70634-4040 2007-02-01
1578601746 Imperial Calcasieu Human Services Authority Clinic/Center 402 Industrial Dr, Oberlin, LA 70655-3519 2007-02-01

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY 1 Lakeshore Dr # 2000, Lake Charles, LA 70629-0100

Office Location

Street Address 1211 N CUTTING AVE
City JENNINGS
State LA
Zip Code 70546-4403

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295374593 Skye Ringuet Assistant Behavior Analyst 611 North State St., Jennings, LA 70546 2020-01-03
1588120612 Southern Home Care Services, Inc Technician 233 N. Main St., Jennings, LA 70546 2019-02-13
1902399249 Calcasieu Urgent Care LLC Clinic/Center 1750 Elton Rd, Jennings, LA 70546 2018-06-12
1407308489 Jefferson Davis Parish Council On Aging Non-emergency Medical Transport (VAN) 210 South State Street, Jennings, LA 70546 2016-10-26
1275906372 Elizabeth Marie Ogea Counselor 203 E Academy Ave, Jennings, LA 70546 2015-11-11
1225401706 Taylor Farris Counselor 1615 Johnston Street, Suite C, Jennings, LA 70546 2015-11-05
1134595622 Karen Lynn Golla Nurse Practitioner 422 Kade Dr Ste 1, Jennings, LA 70546 2015-08-19
1326301615 Lisa Turner Registered Nurse 403 Baker Street, Jennings, LA 70546 2012-06-21
1790057149 Cenikor Foundation Counselor 222 E Academy, Suite A, Jennings, LA 70546 2012-02-01
1821328642 Eric P Lambousy Physical Therapist 1322 Elton Road, Suite I, Jennings, LA 70546 2009-12-29
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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

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1881201192 Guiding Light Mental Health Services, LLC Clinic/Center 2008 Airline Dr Ste 300-215, Bossier City, LA 71111-2946 2020-09-30
1619583341 Resilience Behavioral Healthcare Clinic/Center 801 Woodwind Dr, Alexandria, LA 71303-3888 2020-09-18
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1679182711 Innerspace Counseling Clinic/Center 708 Janice Dr, Sulphur, LA 70663-4210 2020-07-24
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1639794183 Harmony Behavioral Services LLC. Clinic/Center 630 W Cornerview St Ste B, Gonzales, LA 70737-2742 2020-06-10
1477177814 Dr. Phaetra K. Raney Foundation Inc. Clinic/Center 1 Lakeshore Dr Ste 130, Lake Charles, LA 70629-0100 2020-06-02
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Competitor

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City JENNINGS
Zip Code 70546

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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