Healthcare Provider Details

I. General information

NPI: 1194486241
Provider Name (Legal Business Name): EL SHADDAI PSYCHIATRIC CLINIC DBA ADVENT HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 E JOSEPHINE ST
GONZALES LA
70737-3134
US

IV. Provider business mailing address

218 E JOSEPHINE ST
GONZALES LA
70737-3134
US

V. Phone/Fax

Practice location:
  • Phone: 225-673-1088
  • Fax: 225-673-1324
Mailing address:
  • Phone: 225-673-1088
  • Fax: 225-673-1324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SANDRINE NKOUGA
Title or Position: OWNER
Credential:
Phone: 225-577-9009