Full Name | |
---|---|
Speciality | Counselor |
Location | 2005 Claire St, Aretna, Louisiana |
Authorized Official Name and Position | Robert Lee Mullins (PRESIDENT-CEO) |
Authorized Official Contact | 5044671896 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 19408 New Orleans LA 70179 Ph: (504) 467-1896 | 2005 Claire St Aretna LA 70053 Ph: (504) 467-1896 |
NPI Number | 1396818001 |
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Provider Enumeration Date | 11/17/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396818001 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |