| Action Theraputic & Assessment Services Llc | |
|
474 N Foster Dr Baton Rouge LA 70806-3561 | |
| (225) 773-1623 | |
| (225) 774-7422 |
| Full Name | Action Theraputic & Assessment Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 474 N Foster Dr, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Juan Smith (CEO) |
| Authorized Official Contact | 2257731623 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Action Theraputic & Assessment Services Llc 602 Chaleur Dr Baker LA 70714-3810 Ph: (225) 773-1623 | Action Theraputic & Assessment Services Llc 474 N Foster Dr Baton Rouge LA 70806-3561 Ph: (225) 773-1623 |
| NPI Number | 1861760829 |
|---|---|
| Provider Enumeration Date | 12/06/2011 |
| Last Update Date | 12/06/2011 |
| Medicare PECOS PAC ID | 9931374345 |
|---|---|
| Medicare Enrollment ID | O20111214000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861760829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 7718 (Louisiana) | Primary |
| Provider Name | Juan Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760659551 PECOS PAC ID: 6507938123 Enrollment ID: I20080626000337 |
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