| Sage Ltac Llc | |
|
8375 Florida Blvd Denham Springs LA 70726-7806 | |
| (225) 368-3181 | |
| Not Available |
| Full Name | Sage Ltac Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 8375 Florida Blvd, Denham Springs, Louisiana |
| Authorized Official Name and Position | Brett Sandifer (AGENT) |
| Authorized Official Contact | 2253683181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Ltac Llc 10615 Jefferson Hwy Baton Rouge LA 70809-7230 Ph: (225) 368-3181 | Sage Ltac Llc 8375 Florida Blvd Denham Springs LA 70726-7806 Ph: (225) 368-3181 |
| NPI Number | 1720601586 |
|---|---|
| Provider Enumeration Date | 05/27/2020 |
| Last Update Date | 05/27/2020 |
| Certification Date | 05/27/2020 |
| Medicare PECOS PAC ID | 3274807219 |
|---|---|
| Medicare Enrollment ID | O20200630000463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720601586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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