| Dr Concepcion & Associates Therapeutic Ctr | |
|
1131 Rue Du Belier Lafayette LA 70506-6532 | |
| (337) 981-1400 | |
| (337) 981-6611 |
| Full Name | Dr Concepcion & Associates Therapeutic Ctr |
|---|---|
| Speciality | Clinic/Center |
| Location | 1131 Rue Du Belier, Lafayette, Louisiana |
| Authorized Official Name and Position | Violeta Concepcion (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3379811400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Concepcion & Associates Therapeutic Ctr 1131 Rue Du Belier Lafayette LA 70506-6532 Ph: (337) 981-1400 | Dr Concepcion & Associates Therapeutic Ctr 1131 Rue Du Belier Lafayette LA 70506-6532 Ph: (337) 981-1400 |
| NPI Number | 1245407931 |
|---|---|
| Provider Enumeration Date | 05/12/2008 |
| Last Update Date | 03/10/2014 |
| Medicare PECOS PAC ID | 6103850755 |
|---|---|
| Medicare Enrollment ID | O20050922000739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245407931 | NPI | - | NPPES |
| 2084P0800X | Other | TAXONOMY | |
| 11294R | Other | LA | STATE LICENSE |
| 1664448 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 11294R (Louisiana) | Primary |
| Provider Name | Edgardo R. Concepcion |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326123415 PECOS PAC ID: 6103876032 Enrollment ID: I20051116000281 |
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