Healthcare Provider Details

I. General information

NPI: 1366981557
Provider Name (Legal Business Name): ENHANCE HEALTH CARE SERVICES BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1058 E WORTHY ST STE B-2
GONZALES LA
70737-4359
US

IV. Provider business mailing address

1058 E WORTHY ST STE B-2
GONZALES LA
70737-4359
US

V. Phone/Fax

Practice location:
  • Phone: 225-450-3216
  • Fax: 225-450-3799
Mailing address:
  • Phone: 225-450-3216
  • Fax: 225-450-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. VERONICA BROWN SMITH
Title or Position: OWNER
Credential: RN
Phone: 225-450-3216