Journey On The Bayou | |
38250 Susan Ct Gonzales LA 70737-6079 | |
(225) 485-9985 | |
Not Available |
Full Name | Journey On The Bayou |
---|---|
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 38250 Susan Ct, Gonzales, Louisiana |
Authorized Official Name and Position | Alfreda M Fulton (OWNER/ADMINISTRATOR/COUNSELOR) |
Authorized Official Contact | 2254859985 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Journey On The Bayou 38250 Susan Ct Gonzales LA 70737-6079 Ph: (225) 485-9985 | Journey On The Bayou 38250 Susan Ct Gonzales LA 70737-6079 Ph: (225) 485-9985 |
NPI Number | 1407561533 |
---|---|
Provider Enumeration Date | 01/23/2023 |
Last Update Date | 01/23/2023 |
Certification Date | 01/23/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407561533 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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