Healthcare Provider Details

I. General information

NPI: 1619204492
Provider Name (Legal Business Name): PREVENTIVE MEASURES PROGRAMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2009
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 N BEECH ST
TALLULAH LA
71282-3809
US

IV. Provider business mailing address

PO BOX 9177
MONROE LA
71211-9177
US

V. Phone/Fax

Practice location:
  • Phone: 318-574-0098
  • Fax: 318-574-0066
Mailing address:
  • Phone: 318-574-0098
  • Fax: 318-574-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CARLA HOLMES
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-614-5445