| Michael J Thomas Enterprise Llc | |
|
2529 19th St Lake Charles LA 70601-8143 | |
| (337) 377-7667 | |
| Not Available |
| Full Name | Michael J Thomas Enterprise Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2529 19th St, Lake Charles, Louisiana |
| Authorized Official Name and Position | Michael Thomas (CEO) |
| Authorized Official Contact | 3373777667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J Thomas Enterprise Llc 2529 19th St Lake Charles LA 70601-8143 Ph: (337) 377-7667 | Michael J Thomas Enterprise Llc 2529 19th St Lake Charles LA 70601-8143 Ph: (337) 377-7667 |
| NPI Number | 1043858343 |
|---|---|
| Provider Enumeration Date | 12/17/2019 |
| Last Update Date | 12/17/2019 |
| Certification Date | 12/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043858343 | NPI | - | NPPES |
| 20-07179114 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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