Healthcare Provider Details

I. General information

NPI: 1154787554
Provider Name (Legal Business Name): ECL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2016
Last Update Date: 01/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 E MILTON AVE
YOUNGSVILLE LA
70592-5346
US

IV. Provider business mailing address

2445 E MILTON AVE
YOUNGSVILLE LA
70592-5346
US

V. Phone/Fax

Practice location:
  • Phone: 337-451-5952
  • Fax: 337-451-5953
Mailing address:
  • Phone: 337-451-5952
  • Fax: 337-451-5953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number025580
License Number StateLA

VIII. Authorized Official

Name: DR. EDWARD CHARLES LAFLEUR
Title or Position: M.D.
Credential: M.D.
Phone: 337-451-5952