| Gulf Coast Behavioral Health, Llc | |
|
37283 Swamp Rd Ste 803 Prairieville LA 70769-3329 | |
| (225) 254-9589 | |
| (225) 208-7267 |
| Full Name | Gulf Coast Behavioral Health, Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 37283 Swamp Rd Ste 803, Prairieville, Louisiana |
| Authorized Official Name and Position | Cristy Stibal (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 2088211032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Behavioral Health, Llc 37283 Swamp Rd Ste 803 Prairieville LA 70769-3329 Ph: (225) 254-9589 | Gulf Coast Behavioral Health, Llc 37283 Swamp Rd Ste 803 Prairieville LA 70769-3329 Ph: (225) 254-9589 |
| NPI Number | 1043956527 |
|---|---|
| Provider Enumeration Date | 05/09/2022 |
| Last Update Date | 03/31/2023 |
| Certification Date | 03/31/2023 |
| Medicare PECOS PAC ID | 6800275488 |
|---|---|
| Medicare Enrollment ID | O20220628002932 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043956527 | NPI | - | NPPES |
| Provider Name | Monique P Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588184220 PECOS PAC ID: 6507130341 Enrollment ID: I20170918003240 |
| Provider Name | Tina D Malonson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902437270 PECOS PAC ID: 2961801295 Enrollment ID: I20210519000203 |
| Provider Name | Karl Winegar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780138206 PECOS PAC ID: 5890052146 Enrollment ID: I20220628002806 |
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