| |
318 E Park St Crowley LA 70526-2468 | |
(337) 788-3600 | |
(337) 785-1188 |
Full Name | |
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Speciality | Clinic/Center |
Location | 318 E Park St, Crowley, Louisiana |
Authorized Official Name and Position | Lecy L Broussard (MEMBER) |
Authorized Official Contact | 3372777524 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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318 E Park St Crowley LA 70526-2468 Ph: (337) 788-3600 | 318 E Park St Crowley LA 70526-2468 Ph: (337) 788-3600 |
NPI Number | 1841245461 |
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Provider Enumeration Date | 05/23/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 4688687593 |
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Medicare Enrollment ID | O20060719000122 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841245461 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Lecy L Albarado |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346295458 PECOS PAC ID: 7315950235 Enrollment ID: I20060725000035 |
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