=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770435695
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEURO CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2026
-----------------------------------------------------
Last Update Date | 02/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 WILHITE ST
-----------------------------------------------------
City | WEST MONROE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71291-7363
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-582-5117
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 WILHITE ST
-----------------------------------------------------
City | WEST MONROE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71291-7363
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-582-5117
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JACQUELINE CARTER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 414-336-5277
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------