| The Village Life Center, Llc | |
|
58155 Chinn St Ste B Plaquemine LA 70764-3601 | |
| (225) 385-4543 | |
| (866) 825-9703 |
| Full Name | The Village Life Center, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 58155 Chinn St Ste B, Plaquemine, Louisiana |
| Authorized Official Name and Position | Ayanna Carr (CEO) |
| Authorized Official Contact | 9197238799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Village Life Center, Llc 9660 Falls Of Neuse Rd Ste 138 Raleigh NC 27615-2435 Ph: (919) 723-8799 | The Village Life Center, Llc 58155 Chinn St Ste B Plaquemine LA 70764-3601 Ph: (225) 385-4543 |
| NPI Number | 1144634528 |
|---|---|
| Provider Enumeration Date | 06/13/2014 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5092094292 |
|---|---|
| Medicare Enrollment ID | O20171116002791 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144634528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (North Carolina) | Primary |
| Provider Name | Chandra M Katta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831131499 PECOS PAC ID: 2567460017 Enrollment ID: I20061117000352 |
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