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>> Residential Treatment Facility, Emotionally Disturbed Children >> Residential Treatment Facilities

Registrant NPI Number: 1386886653

Individual Registrant:
Gender: F
Sole Proprietor

Location and contact information for practice:
77650 H AND H STREET  MARINGOUIN, LA 70757-0299 US
Tel: 225-806-2854  Fax: 225-625-3358

Contact information for business:
77650 H AND H STREET  MARINGOUIN, LA 70757-0299 US
Tel: 225-806-2854  Fax: 225-625-3358

Registration Information:
NPI: 1386886653
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y322D00000XResidential Treatment Facilities
Residential Treatment Facility, Emotionally Disturbed Children

Legacy codes, insurance codes and state license numbers:



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