| Provision Rehab | |
|
113 South Dr Natchitoches LA 71457-5039 | |
| (318) 238-4030 | |
| Not Available |
| Full Name | Provision Rehab |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 113 South Dr, Natchitoches, Louisiana |
| Authorized Official Name and Position | Deadrian Andrell Alexander-ficklin (CEO) |
| Authorized Official Contact | 3182384030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provision Rehab 113 South Dr Natchitoches LA 71457-5039 Ph: (318) 542-9367 | Provision Rehab 113 South Dr Natchitoches LA 71457-5039 Ph: (318) 238-4030 |
| NPI Number | 1073826681 |
|---|---|
| Provider Enumeration Date | 07/23/2010 |
| Last Update Date | 02/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073826681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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