| South Lafourche Mental Health Clinic | |
|
127 E 123rd St Galliano LA 70354-4223 | |
| (985) 632-2175 | |
| (985) 632-8651 |
| Full Name | South Lafourche Mental Health Clinic |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 127 E 123rd St, Galliano, Louisiana |
| Authorized Official Name and Position | Kent St. Germain (MENTAL HEALTH REGIONAL DIRECTOR) |
| Authorized Official Contact | 9858573673 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Lafourche Mental Health Clinic 127 E 123rd St Galliano LA 70354-4223 Ph: (985) 632-2175 | South Lafourche Mental Health Clinic 127 E 123rd St Galliano LA 70354-4223 Ph: (985) 632-2175 |
| NPI Number | 1518139146 |
|---|---|
| Provider Enumeration Date | 03/24/2008 |
| Last Update Date | 11/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518139146 | NPI | - | NPPES |
| 1710270 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 86 (Louisiana) | Primary |