| Southeast Louisiana State Hospital | |
|
23515 Hwy 190 Southeast Louisiana State Hospital Mandeville LA 70448 | |
| (985) 626-6300 | |
| (985) 626-6557 |
| Full Name | Southeast Louisiana State Hospital |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 23515 Hwy 190, Mandeville, Louisiana |
| Authorized Official Name and Position | Patricia B Gonzales (CEO) |
| Authorized Official Contact | 9156266300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Louisiana State Hospital Po Box 3850 Southeast Louisiana State Hospital Mandeville LA 70470-3850 Ph: (985) 626-6300 | Southeast Louisiana State Hospital 23515 Hwy 190 Southeast Louisiana State Hospital Mandeville LA 70448 Ph: (985) 626-6300 |
| NPI Number | 1518129907 |
|---|---|
| Provider Enumeration Date | 06/27/2008 |
| Last Update Date | 06/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518129907 | NPI | - | NPPES |
| 1946109 | Medicaid | LA | |
| 5D455 | Other | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 214 (Louisiana) | Primary |
Lurline Smith Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Wilkinson St, Mandeville, LA 70448 Phone: 985-624-4450 | |
C Hope Health Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1402 N Causeway Blvd, Apt. 608, Mandeville, LA 70471 Phone: 770-743-7055 | |
Northlake Behavioral Health System Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 23515 Hwy 190, Mandeville, LA 70448 Phone: 847-452-4585 Fax: 985-626-6559 | |
Northlake Medical Psychology And Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 Saint Ann Dr Ste 2, Mandeville, LA 70471 Phone: 601-946-1844 | |
Northshore Zen Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2000 N Causeway Blvd Ste B, Mandeville, LA 70471 Phone: 985-882-1322 Fax: 985-809-6909 | |
Lifenet Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4070 Lonesome Rd, Suite B, Mandeville, LA 70448 Phone: 985-246-2600 Fax: 985-246-2601 | |
Michele Marie Mixon, Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2244 11th St, Mandeville, LA 70471 Phone: 225-266-8122 |