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4606 Lee St Alexandria LA 71302-3235 | |
| (318) 442-3163 | |
| (318) 442-4779 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4606 Lee St, Alexandria, Louisiana |
| Authorized Official Name and Position | Mark J Cullen (CEO) |
| Authorized Official Contact | 3377858003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
426 N Avenue G Crowley LA 70526-4438 Ph: (337) 785-8003 | 4606 Lee St Alexandria LA 71302-3235 Ph: (318) 442-3163 |
| NPI Number | 1093802795 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 07/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093802795 | NPI | - | NPPES |
| 60104 | Other | LA | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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