| Back To The Real World Llc | |
|
234 Rue Beauregard Ste 100 Lafayette LA 70508-3285 | |
| (337) 593-0830 | |
| (337) 593-0122 |
| Full Name | Back To The Real World Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 234 Rue Beauregard, Lafayette, Louisiana |
| Authorized Official Name and Position | Melissa M Gad (GENERAL PARTNER) |
| Authorized Official Contact | 3375930830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Back To The Real World Llc 234 Rue Beauregard Ste 100 Lafayette LA 70508-3285 Ph: (337) 593-0830 | Back To The Real World Llc 234 Rue Beauregard Ste 100 Lafayette LA 70508-3285 Ph: (337) 593-0830 |
| NPI Number | 1477870053 |
|---|---|
| Provider Enumeration Date | 04/22/2010 |
| Last Update Date | 04/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477870053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 11569R (Louisiana) | Primary |
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