ALLEN OUTREACH INC. - NPI NUMBER 1124341425

Summary

Provider Name: ALLEN OUTREACH INC.

NPI Number: 1124341425

Clasification: Community/Behavioral Health (251S00000X)

Address:
113 N 13TH ST
OAKDALE, LA
ZIP 71463

Phone Number: (318) 335-3578



Detailed Information

ALLEN OUTREACH INC. is a community/behavioral health in Oakdale, LA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. The assigned NPI number for this provider is 1124341425 and is registered as an organization entity type.

The provider's business address is:

113 N 13TH ST
OAKDALE, LA
ZIP 71463-742
Phone: (318) 335-3578
Fax: (318) 335-3753

The provider's authorized official is Scott Lejeune .
The authorized official title is Clinical Supervisor and has the following contact phone number (318) 335-3578.

The enumeration date for this NPI number is 3/2/2010 and was last updated on 10/15/2010.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 251S00000X Community/Behavioral Health 220 LA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 10885 OTHER LA LA ADDICTIVE DISORDERS (LADDS)
2 250 OTHER LA LA DEPARTMENT OF HEALTH & HOSPITALS

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1124341425 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name ALLEN OUTREACH INC. The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 113 N 13TH ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name OAKDALE The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name LA The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 714632742 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 3183353578 The telephone number associated with the location address of the provider being identified.
11 Provider Business Practice Location Address Fax Number 3183353753 The fax number associated with the location address of the provider being identified.
12 Provider Enumeration Date 3/2/2010 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 10/15/2010 The date that a record was last updated or changed.
14 Authorized Official Last Name LEJEUNE The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
15 Authorized Official First Name SCOTT The first name of the authorized official.
16 Authorized Official Title or Position CLINICAL SUPERVISOR The title or position of the authorized official.
17 Authorized Official Telephone Number 3183353578 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 251S00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Provider License Number 1 220 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
20 Provider License Number State Code 1 LA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 10885 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier Type Code 1 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
24 Other Provider Identifier State 1 LA
25 Other Provider Identifier Issuer 1 LA ADDICTIVE DISORDERS (LADDS)
26 Other Provider Identifier 2 250 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier Type Code 2 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
28 Other Provider Identifier State 2 LA
29 Other Provider Identifier Issuer 2 LA DEPARTMENT OF HEALTH & HOSPITALS
30 Is Organization Subpart N
31 Authorized Official Name Prefix Text DR.
32 Authorized Official Credential Text LPC-S, LMFT

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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