| |
13101 River Rd Luling LA 70070-4165 | |
(985) 331-1999 | |
(985) 331-2353 |
Full Name | |
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Speciality | Counselor - Professional |
Location | 13101 River Rd, Luling, Louisiana |
Authorized Official Name and Position | Eric Dishongh (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9853311999 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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13101 River Rd Luling LA 70070-4165 Ph: (985) 331-1999 | 13101 River Rd Luling LA 70070-4165 Ph: (985) 331-1999 |
NPI Number | 1164798880 |
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Provider Enumeration Date | 03/27/2012 |
Last Update Date | 09/28/2022 |
Certification Date | 09/28/2022 |
Identifier | Type | State | Issuer |
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1164798880 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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