| Fundamentals, LLC | |
|
60 Louis Prima Dr Suite A Covington LA 70433-5903 | |
| (504) 430-6116 | |
| (866) 300-8753 |
| Full Name | Fundamentals, LLC |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 60 Louis Prima Dr, Covington, Louisiana |
| Authorized Official Name and Position | Colette Melancon (OWNER) |
| Authorized Official Contact | 5044306116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fundamentals, LLC 60 Louis Prima Dr Suite A Covington LA 70433-5903 Ph: (504) 430-6116 | Fundamentals, LLC 60 Louis Prima Dr Suite A Covington LA 70433-5903 Ph: (504) 430-6116 |
| NPI Number | 1023262383 |
|---|---|
| Provider Enumeration Date | 11/12/2008 |
| Last Update Date | 01/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023262383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3700 (Louisiana) | Primary |
| 1041C0700X | Social Worker - Clinical | 3883 (Louisiana) | Secondary |
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