Miracle Place Inc | |
117 N Washington St Bastrop LA 71220-3842 | |
(318) 556-3378 | |
Not Available |
Full Name | Miracle Place Inc |
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Speciality | Community/behavioral Health |
Location | 117 N Washington St, Bastrop, Louisiana |
Authorized Official Name and Position | Cynthia Taylor (ADMINISTRATOR) |
Authorized Official Contact | 3185099376 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Miracle Place Inc 117 N Washington St Bastrop LA 71220-3842 Ph: () - | Miracle Place Inc 117 N Washington St Bastrop LA 71220-3842 Ph: (318) 556-3378 |
NPI Number | 1487028163 |
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Provider Enumeration Date | 11/18/2015 |
Last Update Date | 11/18/2015 |
Identifier | Type | State | Issuer |
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1487028163 | NPI | - | NPPES |
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