| Tallulah Behavioral Health Clinic | |
|
1012 Johnson St Tallulah LA 71282-5216 | |
| (318) 574-1713 | |
| (381) 574-2299 |
| Full Name | Tallulah Behavioral Health Clinic |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1012 Johnson St, Tallulah, Louisiana |
| Authorized Official Name and Position | Octavia Green (ADMINSITRATIVE PROGRAM SPECIALIST B) |
| Authorized Official Contact | 3183623270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tallulah Behavioral Health Clinic 1012 Johnson St Tallulah LA 71282-5216 Ph: (318) 574-1713 | Tallulah Behavioral Health Clinic 1012 Johnson St Tallulah LA 71282-5216 Ph: (318) 574-1713 |
| NPI Number | 1689016487 |
|---|---|
| Provider Enumeration Date | 07/22/2013 |
| Last Update Date | 10/06/2023 |
| Certification Date | 10/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689016487 | NPI | - | NPPES |
| 1710351 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2203782765 (Louisiana) | Primary |
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