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General NPI Number Information
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NPI Number | 1144742248
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Entity Type | Organization
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Legal Business Name | GUIDANCE FOR BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1204 STUBBS AVE STE B
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City | MONROE
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State | LA
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Zip | 71201-5631
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Country | US
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Telephone | 318-582-5633
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Fax | 318-582-5646
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Provider Business Mailing Address
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Address Line | 1204 STUBBS AVE STE B
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City | MONROE
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State | LA
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Zip | 71201-5631
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Country | US
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Telephone | 318-582-5633
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Fax | 318-582-5646
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Authorized Official
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Title or Position | CEO
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Name | MR. RODERICK T WILLIAMS JR.
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Credential |
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Telephone | 318-582-5633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2203783384
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License Number State | LA
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