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320 S Franklin St Bastrop LA 71220-4539 | |
(318) 283-0868 | |
(318) 283-0875 |
Full Name | |
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Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 320 S Franklin St, Bastrop, Louisiana |
Authorized Official Name and Position | Phyllis Jerri Parks (OAD/REGIONAL ADMINISTRATOR) |
Authorized Official Contact | 3183623270 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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320 S Franklin St Bastrop LA 71220-4539 Ph: (318) 283-0868 | 320 S Franklin St Bastrop LA 71220-4539 Ph: (318) 283-0868 |
NPI Number | 1174589022 |
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Provider Enumeration Date | 04/20/2006 |
Last Update Date | 08/25/2010 |
Identifier | Type | State | Issuer |
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1174589022 | NPI | - | NPPES |
G3195 | Other | LA | BCBS |
Therapeutic Interventions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9080 Westwood Dr., Null, Bastrop, LA 71220 Phone: 318-237-8000 | |