| Lafayette Senior Club | |
|
1011 Surrey St Lafayette LA 70501-6142 | |
| (337) 654-5519 | |
| Not Available |
| Full Name | Lafayette Senior Club |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1011 Surrey St, Lafayette, Louisiana |
| Authorized Official Name and Position | Donna Mcpherson (BOAD MEMBER) |
| Authorized Official Contact | 3184456470 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lafayette Senior Club 4333 Shreveport Hwy Pineville LA 71360-3828 Ph: (318) 445-6470 | Lafayette Senior Club 1011 Surrey St Lafayette LA 70501-6142 Ph: (337) 654-5519 |
| NPI Number | 1982901104 |
|---|---|
| Provider Enumeration Date | 02/24/2011 |
| Last Update Date | 02/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982901104 | NPI | - | NPPES |
| 2121936 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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