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General NPI Number Information
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NPI Number | 1629027602
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Entity Type | Organization
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Legal Business Name | LIFECARE PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 216 ROBIN LN
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City | OPELOUSAS
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State | LA
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Zip | 70570-9149
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Country | US
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Telephone | 337-948-5055
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Fax | 337-942-1060
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Provider Business Mailing Address
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Address Line | 201 RUE BEAUREGARD SUITE 202
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City | LAFAYETTE
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State | LA
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Zip | 70508-3251
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Country | US
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Telephone | 337-593-0108
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Fax | 337-593-9579
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Authorized Official
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Title or Position | OWNER
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Name | MS. BERYL D CORMIER
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Credential |
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Telephone | 337-593-0108
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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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