| Pegasus Behavioral Services Llc | |
|
400 Mariners Plaza Dr Ste 409d Mandeville LA 70448-6849 | |
| (985) 224-0412 | |
| (985) 202-9331 |
| Full Name | Pegasus Behavioral Services Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 400 Mariners Plaza Dr Ste 409d, Mandeville, Louisiana |
| Authorized Official Name and Position | Kimberly Davis (CREDENTIALING SPECIALISTS) |
| Authorized Official Contact | 9123734385 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pegasus Behavioral Services Llc 116 Carmel Dr Mandeville LA 70448-4127 Ph: (985) 224-0412 | Pegasus Behavioral Services Llc 400 Mariners Plaza Dr Ste 409d Mandeville LA 70448-6849 Ph: (985) 224-0412 |
| NPI Number | 1689274698 |
|---|---|
| Provider Enumeration Date | 10/28/2020 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689274698 | NPI | - | NPPES |
| 6961 | Other | LA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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