| Psychiatric Solutions Llc | |
|
1101 Audubon Ave Thibodaux LA 70301-4957 | |
| (985) 209-0953 | |
| (941) 295-7336 |
| Full Name | Psychiatric Solutions Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1101 Audubon Ave, Thibodaux, Louisiana |
| Authorized Official Name and Position | Sandra Brommeland Gonzalez (OWNER) |
| Authorized Official Contact | 9852090953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Solutions Llc 929 Bayou Dularge Rd Houma LA 70363-7614 Ph: (985) 209-0953 | Psychiatric Solutions Llc 1101 Audubon Ave Thibodaux LA 70301-4957 Ph: (985) 209-0953 |
| NPI Number | 1184913451 |
|---|---|
| Provider Enumeration Date | 04/07/2011 |
| Last Update Date | 01/27/2015 |
| Medicare PECOS PAC ID | 3375708860 |
|---|---|
| Medicare Enrollment ID | O20120709000166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184913451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | APO5139 (Louisiana) | Primary |
| Provider Name | Sandra L Brommeland-gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053428342 PECOS PAC ID: 3971602673 Enrollment ID: I20070621000026 |
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