| Mcmains Children's Developmental Center | |
|
1805 College Dr Baton Rouge LA 70808-1919 | |
| (225) 923-3420 | |
| (225) 922-9316 |
| Full Name | Mcmains Children's Developmental Center |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1805 College Dr, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Janet C. Ketcham (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2259233420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcmains Children's Developmental Center 1805 College Dr Baton Rouge LA 70808-1919 Ph: (225) 923-3420 | Mcmains Children's Developmental Center 1805 College Dr Baton Rouge LA 70808-1919 Ph: (225) 923-3420 |
| NPI Number | 1144224031 |
|---|---|
| Provider Enumeration Date | 06/08/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144224031 | NPI | - | NPPES |
| 1394149 | Medicaid | LA | |
| 02587 | Other | LA | BLUE CROSS PROVIDER |
| 1930423 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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