| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | Po Box 2376, Jena, Louisiana |
| Authorized Official Name and Position | Jasmine Furlow (MENTAL HEALTH SPECIALIST) |
| Authorized Official Contact | 3189922263 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2376 Jena LA 71342-2376 Ph: (318) 992-2263 | Po Box 2376 Jena LA 71342-2376 Ph: (318) 992-2263 |
| NPI Number | 1205347747 |
|---|---|
| Provider Enumeration Date | 10/23/2017 |
| Last Update Date | 10/23/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205347747 | NPI | - | NPPES |
| 1912281031 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Pauls Intervention Service Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 165 Sonny Ln, Jena, LA 71342 Phone: 318-992-5677 Fax: 318-992-5677 | |
Another Chance Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1884 N 1st Street, Jena, LA 71342 Phone: 318-992-2730 Fax: 318-992-2730 | |