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General NPI Number Information
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NPI Number | 1699959924
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Entity Type | Organization
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Legal Business Name | HEALTHY CHOICES, LLC
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 4051 GROOM RD SUITE A
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City | BAKER
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State | LA
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Zip | 70714-3566
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Country | US
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Telephone | 225-222-3008
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Fax |
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Provider Business Mailing Address
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Address Line | 4051 GROOM RD SUITE A
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City | BAKER
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State | LA
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Zip | 70714-3566
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Country | US
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Telephone | 225-505-3285
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ASHTON SPEARS
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Credential |
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Telephone | 225-505-3285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 12757
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License Number State | LA
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