| Rustic Roots Counseling Center, Llc | |
|
17541 Eagles Perch Dr Prairieville LA 70769-6069 | |
| (337) 254-2629 | |
| Not Available |
| Full Name | Rustic Roots Counseling Center, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 17541 Eagles Perch Dr, Prairieville, Louisiana |
| Authorized Official Name and Position | Shereva S Lewis (OWNER) |
| Authorized Official Contact | 3372542629 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rustic Roots Counseling Center, Llc 17541 Eagles Perch Dr Prairieville LA 70769-6069 Ph: (337) 254-2629 | Rustic Roots Counseling Center, Llc 17541 Eagles Perch Dr Prairieville LA 70769-6069 Ph: (337) 254-2629 |
| NPI Number | 1306512686 |
|---|---|
| Provider Enumeration Date | 08/18/2021 |
| Last Update Date | 08/18/2021 |
| Certification Date | 08/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306512686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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