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General NPI Number Information
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NPI Number | 1003779604
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Entity Type | Organization
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Legal Business Name | REDEFINE BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 711 E. ASCENSION ST
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City | GONZALES
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State | LA
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Zip | 70737
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Country | US
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Telephone | 225-400-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 2388 LA 44
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City | PAULINA
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State | LA
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Zip | 70763-2703
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Country | US
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Telephone | 225-400-0000
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Fax |
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Authorized Official
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Title or Position | NURSE PRACICITIONER/ OWNER
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Name | MRS. TRINEASE CHANTELE SANDERS
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Credential | APRN, MSN, PMHNP-BC
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Telephone | 225-252-5506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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