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1125 W Highway 30 Gonzales LA 70737-5004 | |
(225) 674-5075 | |
(225) 674-6066 |
Full Name | |
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Speciality | Psychiatric Unit |
Location | 1125 W Highway 30, Gonzales, Louisiana |
Authorized Official Name and Position | Dolores Lejeune (PRESIDENT & CHIEF OPERATING OFFICER) |
Authorized Official Contact | 2256475075 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1125 W Highway 30 Gonzales LA 70737-5004 Ph: (225) 674-5075 | 1125 W Highway 30 Gonzales LA 70737-5004 Ph: (225) 674-5075 |
NPI Number | 1457348336 |
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Provider Enumeration Date | 10/05/2005 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1457348336 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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