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202 N Vine St Bastrop LA 71220-3749 | |
(318) 281-4195 | |
(318) 281-4196 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 202 N Vine St, Bastrop, Louisiana |
Authorized Official Name and Position | Yolanda Henderson (DIRECTOR/OWNER) |
Authorized Official Contact | 3186142962 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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55 Northgate Dr Monroe LA 71201-2214 Ph: () - | 202 N Vine St Bastrop LA 71220-3749 Ph: (318) 281-4195 |
NPI Number | 1306225867 |
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Provider Enumeration Date | 05/29/2015 |
Last Update Date | 05/29/2015 |
Identifier | Type | State | Issuer |
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1306225867 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Therapeutic Interventions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9080 Westwood Dr., Null, Bastrop, LA 71220 Phone: 318-237-8000 | |