| Miss-lou Addiction Clinic | |
|
525 Alexander St Jonesboro LA 71251-2001 | |
| (601) 442-0270 | |
| (888) 981-2815 |
| Full Name | Miss-lou Addiction Clinic |
|---|---|
| Speciality | Case Manager/care Coordinator |
| Location | 525 Alexander St, Jonesboro, Louisiana |
| Authorized Official Name and Position | Mona Lisa Peterson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6014420270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miss-lou Addiction Clinic 1000 Chinaberry Dr Ste 903 Bossier City LA 71111-2455 Ph: (318) 459-6795 | Miss-lou Addiction Clinic 525 Alexander St Jonesboro LA 71251-2001 Ph: (601) 442-0270 |
| NPI Number | 1205354974 |
|---|---|
| Provider Enumeration Date | 09/01/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 12/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205354974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1112895 (Mississippi) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
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