<unavail> in Gonzales, LA - Medicare Clinic/Center

is a medicare enrolled mental health clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in Gonzales, Louisiana. The current practice location for is 630 W Cornerview St, Gonzales, Louisiana. For appointments, you can reach them via phone at (225) 647-4105. The mailing address for is Po Box 359, Gonzales, Louisiana and phone number is (225) 647-4105.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1154855591. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (225) 647-4105.

Contact Information


	630 W Cornerview St Gonzales LA 70737-2742
	(225) 647-4105
	(866) 234-8190

Map and Direction

Mental Health Clinic Profile

Full Name
Speciality	Clinic/Center
Location	630 W Cornerview St, Gonzales, Louisiana
Authorized Official Name and Position	Demarcus D Patterson (OWNER)
Authorized Official Contact	2256474105
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 359 Gonzales LA 70707-0359 Ph: (225) 647-4105	630 W Cornerview St Gonzales LA 70737-2742 Ph: (225) 647-4105

NPI Details:

NPI Number	1154855591
Provider Enumeration Date	04/12/2017
Last Update Date	10/09/2019

Medicare PECOS Information:

Medicare PECOS PAC ID	4880022250
Medicare Enrollment ID	O20200318000436

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154855591	NPI	-	NPPES
1154855591	Medicaid	LA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
251S00000X	Community/behavioral Health	2203783205 (Louisiana)	Secondary
261QM0801X	Clinic/center - Mental Health (including Community Mental Health Center)	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Lajuan B Brown
Provider Type	Practitioner - Clinical Social Worker
Provider Identifiers	NPI Number: 1689004145 PECOS PAC ID: 4880944685 Enrollment ID: I20180828003773

Provider Name	Aleshia Dennis
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1467818880 PECOS PAC ID: 1658705991 Enrollment ID: I20191219002424

Reviews and Comments

Clinic/Center in Gonzales, LA

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- Medicare Mental Health Clinic in Gonzales, LA