Healthcare Provider Details

I. General information

NPI: 1003035825
Provider Name (Legal Business Name): VERMILION BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N FOOTE AVE
KAPLAN LA
70548-3030
US

IV. Provider business mailing address

710 N FOOTE AVE
KAPLAN LA
70548-3030
US

V. Phone/Fax

Practice location:
  • Phone: 337-643-7333
  • Fax: 337-643-7338
Mailing address:
  • Phone: 337-643-7333
  • Fax: 337-643-7338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateLA

VIII. Authorized Official

Name: MRS. CHRIS S GUIDRY
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 337-643-7333