| Michael Gaines And Faith, Llc | |
|
2944 Ray Weiland Dr Baker LA 70714-3250 | |
| (225) 636-2638 | |
| (225) 778-5068 |
| Full Name | Michael Gaines And Faith, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2944 Ray Weiland Dr, Baker, Louisiana |
| Authorized Official Name and Position | Michael Dan Gaines (DIRECTOR) |
| Authorized Official Contact | 2256362638 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Gaines And Faith, Llc Po Box 157 Baker LA 70704-0157 Ph: (225) 636-2638 | Michael Gaines And Faith, Llc 2944 Ray Weiland Dr Baker LA 70714-3250 Ph: (225) 636-2638 |
| NPI Number | 1043557275 |
|---|---|
| Provider Enumeration Date | 01/08/2013 |
| Last Update Date | 09/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043557275 | NPI | - | NPPES |
| 1438341 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1656 (Louisiana) | Primary |
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