| Quazi-private Entity | |
|
640 Avenue V Bogalusa LA 70427-4456 | |
| (985) 735-5216 | |
| (985) 735-1923 |
| Full Name | Quazi-private Entity |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 640 Avenue V, Bogalusa, Louisiana |
| Authorized Official Name and Position | Elizabeth Joel Schilling (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9857355216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Quazi-private Entity 640 Avenue V Bogalusa LA 70427-4456 Ph: (985) 735-5216 | Quazi-private Entity 640 Avenue V Bogalusa LA 70427-4456 Ph: (985) 735-5216 |
| NPI Number | 1538327820 |
|---|---|
| Provider Enumeration Date | 05/23/2008 |
| Last Update Date | 05/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538327820 | NPI | - | NPPES |
| 1934160 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 10005 (Louisiana) | Primary |
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