| Louisiana Health & Rehabilitation Coptions | |
|
930 Webb St Lafayette LA 70501-3930 | |
| (337) 267-7375 | |
| (337) 269-5615 |
| Full Name | Louisiana Health & Rehabilitation Coptions |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 930 Webb St, Lafayette, Louisiana |
| Authorized Official Name and Position | Soundra Johnson Temple (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2259380661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisiana Health & Rehabilitation Coptions 1033 N Lobdell Ave Baton Rouge LA 70806-2233 Ph: (225) 231-2490 | Louisiana Health & Rehabilitation Coptions 930 Webb St Lafayette LA 70501-3930 Ph: (337) 267-7375 |
| NPI Number | 1215149950 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215149950 | NPI | - | NPPES |
| 1453773 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | PCA 11826 (Louisiana) | Primary |
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