| The Ministry Of Reconciliation, Inc | |
|
735 West Dr Deridder LA 70634-3410 | |
| (985) 312-2525 | |
| (337) 202-4042 |
| Full Name | The Ministry Of Reconciliation, Inc |
|---|---|
| Speciality | Counselor |
| Location | 735 West Dr, Deridder, Louisiana |
| Authorized Official Name and Position | Martin James Romero (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9853122525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Ministry Of Reconciliation, Inc Po Box 344 Deridder LA 70634-0344 Ph: (985) 312-2525 | The Ministry Of Reconciliation, Inc 735 West Dr Deridder LA 70634-3410 Ph: (985) 312-2525 |
| NPI Number | 1659763738 |
|---|---|
| Provider Enumeration Date | 02/25/2015 |
| Last Update Date | 02/25/2015 |
| Medicare PECOS PAC ID | 6103366760 |
|---|---|
| Medicare Enrollment ID | O20240910001650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659763738 | NPI | - | NPPES |
| 11855485 | Other | LA | CAQH |
| 600887225 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC #4906 (Louisiana) | Primary |
| Provider Name | Martin James Romero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538361811 PECOS PAC ID: 5698076743 Enrollment ID: I20240910002038 |
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