| New Leaf Behavioral Health Clinicians, Llc | |
|
2905 Fiske Street Lake Charles LA 70601-8550 | |
| (337) 476-1338 | |
| Not Available |
| Full Name | New Leaf Behavioral Health Clinicians, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2905 Fiske Street, Lake Charles, Louisiana |
| Authorized Official Name and Position | Horatio Acquinaldo Millin (OWNER/MANAGER) |
| Authorized Official Contact | 3374761338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Leaf Behavioral Health Clinicians, Llc 2905 Fiske Street Lake Charles LA 70601-8550 Ph: (337) 476-1338 | New Leaf Behavioral Health Clinicians, Llc 2905 Fiske Street Lake Charles LA 70601-8550 Ph: (337) 476-1338 |
| NPI Number | 1255941902 |
|---|---|
| Provider Enumeration Date | 08/07/2020 |
| Last Update Date | 08/07/2020 |
| Certification Date | 08/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255941902 | NPI | - | NPPES |
| 1049085 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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