| NPI | 1821754193 |
|---|---|
| Doing Business As | LDHS |
| Entity Type | Organization |
| Authorized Contact | AUSTIN GEORGE BENAMON Chief Executive Officer 866-806-5347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QD0000X Clinic/Center, Dental | |
| 101Y00000X Counselor | |
| 152W00000X Optometrist | |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 333600000X Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2021-11-11 |