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21089 South Frontage Road Lacassine LA 70650-9998 | |
(337) 936-9197 | |
(337) 588-4179 |
Full Name | |
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Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 21089 South Frontage Road, Lacassine, Louisiana |
Authorized Official Name and Position | Kelvin Smith (ADMINISTRATOR) |
Authorized Official Contact | 3379369197 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1967 Iowa LA 70647-1967 Ph: (337) 936-9197 | 21089 South Frontage Road Lacassine LA 70650-9998 Ph: (337) 936-9197 |
NPI Number | 1982215851 |
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Provider Enumeration Date | 08/13/2020 |
Last Update Date | 08/29/2023 |
Certification Date | 08/29/2023 |
Identifier | Type | State | Issuer |
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1982215851 | NPI | - | NPPES |