Full Name | |
---|---|
Speciality | Psychiatric Unit |
Location | 1610 7th St, Mamou, Louisiana |
Authorized Official Name and Position | Michael W. Johnson (PRESIDENT) |
Authorized Official Contact | 3374680355 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
801 Poinciana Ave Mamou LA 70554-2243 Ph: (337) 746-0355 | 1610 7th St Mamou LA 70554 Ph: (337) 468-0110 |
NPI Number | 1801122585 |
---|---|
Provider Enumeration Date | 10/30/2009 |
Last Update Date | 06/06/2018 |
Medicare PECOS PAC ID | 1557403953 |
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Medicare Enrollment ID | O20100303001036 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801122585 | NPI | - | NPPES |
1705772 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
273R00000X | Psychiatric Unit | 673E (Louisiana) | Primary |
Mamou Health Resources, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1510 Napoleon St, Mamou, LA 70554 Phone: 337-468-2333 Fax: 337-468-3620 | |