| The Recovery Clinic, Llc | |
|
624 Connell Park Ln Ste A Baton Rouge LA 70806-6534 | |
| (985) 781-0548 | |
| (985) 781-4319 |
| Full Name | The Recovery Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 624 Connell Park Ln Ste A, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Todd Bossier (MANAGER) |
| Authorized Official Contact | 2257733379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Recovery Clinic, Llc Po Box 3327 Slidell LA 70459-3327 Ph: (985) 781-0548 | The Recovery Clinic, Llc 624 Connell Park Ln Ste A Baton Rouge LA 70806-6534 Ph: (985) 781-0548 |
| NPI Number | 1578279089 |
|---|---|
| Provider Enumeration Date | 01/27/2023 |
| Last Update Date | 01/27/2023 |
| Medicare PECOS PAC ID | 4183085574 |
|---|---|
| Medicare Enrollment ID | O20230801004432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578279089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Todd J Bossier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851319602 PECOS PAC ID: 5698661379 Enrollment ID: I20040227000734 |
| Provider Name | Benji J Arboneaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538183108 PECOS PAC ID: 1658377213 Enrollment ID: I20061005000069 |
| Provider Name | Dave J Daigle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033382973 PECOS PAC ID: 3971657685 Enrollment ID: I20110127000472 |
| Provider Name | Cody M Favaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023619277 PECOS PAC ID: 9032524046 Enrollment ID: I20210224000822 |
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