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1847 Sterkx Rd Alexandria LA 71301-3540 | |
| (318) 445-4119 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1847 Sterkx Rd, Alexandria, Louisiana |
| Authorized Official Name and Position | Nathan Russell Provost (CONTROLLER) |
| Authorized Official Contact | 8605397745 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
175 Addison Rd Ste 3 Windsor CT 06095-2179 Ph: (860) 539-7745 | 1847 Sterkx Rd Alexandria LA 71301-3540 Ph: (318) 445-4119 |
| NPI Number | 1740431865 |
|---|---|
| Provider Enumeration Date | 10/07/2008 |
| Last Update Date | 11/01/2023 |
| Certification Date | 11/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740431865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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