Healthcare Provider Details

I. General information

NPI: 1619676467
Provider Name (Legal Business Name): EUREKA INVESTMENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 03/01/2023
Certification Date: 02/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 FINKS HIDEAWAY RD
MONROE LA
71203-2804
US

IV. Provider business mailing address

1300 FINKS HIDEAWAY RD
MONROE LA
71203-2804
US

V. Phone/Fax

Practice location:
  • Phone: 318-816-4919
  • Fax:
Mailing address:
  • Phone: 318-816-4919
  • Fax: 318-302-0689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIJAH W MILLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-450-9281