| Southeast Professional Health Group Llc | |
|
25341 Hwy 1 South Plaquemine LA 70764 | |
| (225) 687-9902 | |
| (225) 687-9903 |
| Full Name | Southeast Professional Health Group Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 25341 Hwy 1 South, Plaquemine, Louisiana |
| Authorized Official Name and Position | Thane Battiste Painia (MANAGER) |
| Authorized Official Contact | 2256879902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Professional Health Group Llc Po Box 291 Plaquemine LA 70765-0291 Ph: (225) 687-9902 | Southeast Professional Health Group Llc 25341 Hwy 1 South Plaquemine LA 70764 Ph: (225) 687-9902 |
| NPI Number | 1861657421 |
|---|---|
| Provider Enumeration Date | 07/23/2008 |
| Last Update Date | 08/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861657421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 194709 (Louisiana) | Primary |
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