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15785 Medical Arts Plaza Hammond LA 70403 | |
| (985) 543-4080 | |
| (985) 543-4090 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 15785 Medical Arts Plaza, Hammond, Louisiana |
| Authorized Official Name and Position | Darlene Marie Jiles (MENTAL HEALTH CENTER MANAGER) |
| Authorized Official Contact | 9855434800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
15785 Medical Arts Plaza Hammond LA 70403 Ph: (985) 543-4080 | 15785 Medical Arts Plaza Hammond LA 70403 Ph: (985) 543-4080 |
| NPI Number | 1487707626 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 12/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487707626 | NPI | - | NPPES |
| 1710164 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 170 (Louisiana) | Primary |
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