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General NPI Number Information
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NPI Number | 1518722271
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Entity Type | Organization
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Legal Business Name | SAMSON BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 02/20/2024
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 2712 RUE CANNES DR
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City | LAKE CHARLES
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State | LA
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Zip | 70605-4044
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Country | US
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Telephone | 337-244-6476
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Fax |
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Provider Business Mailing Address
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Address Line | 2712 RUE CANNES DR
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City | LAKE CHARLES
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State | LA
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Zip | 70605-4044
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Country | US
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Telephone | 337-244-6476
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. JENNIFER L COOK
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Credential | BCBA
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Telephone | 337-244-6476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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