|
| |
|
1112 E Ascension Complex Blvd Gonzales LA 70737-4265 | |
| (225) 621-5775 | |
| (225) 644-2846 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1112 E Ascension Complex Blvd, Gonzales, Louisiana |
| Authorized Official Name and Position | Susan C. Mittendorf (DIRECTOR) |
| Authorized Official Contact | 2256215775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1112 E Ascension Complex Blvd Gonzales LA 70737-4265 Ph: (225) 621-5775 | 1112 E Ascension Complex Blvd Gonzales LA 70737-4265 Ph: (225) 621-5775 |
| NPI Number | 1922117514 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 07/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922117514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | FS 3361 (Louisiana) | Primary |
Rise 'n'shine Counseling Agency Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1724 N Burnside Ave, Suite # 7, Gonzales, LA 70737 Phone: 225-644-8565 | |
Irise Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 S Burnside Ave., 203, Gonzales, LA 70737 Phone: 225-647-9001 Fax: 225-647-9001 | |
Balance And Bloom Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 N Airline Hwy Ste 208, Gonzales, LA 70737 Phone: 985-789-5521 |