| Journey On The Bayou | |
|
38250 Susan Ct Gonzales LA 70737-6079 | |
| (225) 485-9985 | |
| Not Available |
| Full Name | Journey On The Bayou |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 38250 Susan Ct, Gonzales, Louisiana |
| Authorized Official Name and Position | Alfreda M Fulton (OWNER/ADMINISTRATOR/COUNSELOR) |
| Authorized Official Contact | 2254859985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Journey On The Bayou 38250 Susan Ct Gonzales LA 70737-6079 Ph: (225) 485-9985 | Journey On The Bayou 38250 Susan Ct Gonzales LA 70737-6079 Ph: (225) 485-9985 |
| NPI Number | 1407561533 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 01/23/2023 |
| Certification Date | 01/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407561533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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