| Delta Recovery Program | |
|
411 Sparrow St Lake Providence LA 71254-3035 | |
| (318) 559-3356 | |
| (318) 559-2044 |
| Full Name | Delta Recovery Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 411 Sparrow St, Lake Providence, Louisiana |
| Authorized Official Name and Position | Elisha Y Lucas (DIRECTOR) |
| Authorized Official Contact | 3185593356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Recovery Program Po Box 88 Lake Providence LA 71254-0088 Ph: (318) 559-3356 | Delta Recovery Program 411 Sparrow St Lake Providence LA 71254-3035 Ph: (318) 559-3356 |
| NPI Number | 1639612476 |
|---|---|
| Provider Enumeration Date | 11/28/2016 |
| Last Update Date | 11/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639612476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Delta Community Action Association, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Sparrow St, Lake Providence, LA 71254 Phone: 318-559-3356 Fax: 318-559-2044 |