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644 E Jefferson Ave Suite B Bastrop LA 71220-4619 | |
(318) 239-3491 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 644 E Jefferson Ave, Bastrop, Louisiana |
Authorized Official Name and Position | Tania Lovell (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3182393491 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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644 E Jefferson Ave Suite B Bastrop LA 71220-4619 Ph: (318) 239-3491 | 644 E Jefferson Ave Suite B Bastrop LA 71220-4619 Ph: (318) 239-3491 |
NPI Number | 1346781150 |
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Provider Enumeration Date | 03/13/2017 |
Last Update Date | 03/13/2017 |
Identifier | Type | State | Issuer |
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1346781150 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (Louisiana) | Primary |
Therapeutic Interventions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9080 Westwood Dr., Null, Bastrop, LA 71220 Phone: 318-237-8000 | |