Healthcare Provider Details

I. General information

NPI: 1487972030
Provider Name (Legal Business Name): VERMILION BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2010
Last Update Date: 05/06/2010
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

PO BOX 428
CROWLEY LA
70527-0428
US

V. Phone/Fax

Practice location:
  • Phone: 337-643-7333
  • Fax: 337-643-7338
Mailing address:
  • Phone: 337-785-8003
  • Fax: 337-785-8045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MARK CULLEN
Title or Position: CEO
Credential:
Phone: 337-788-3330