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General NPI Number Information
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NPI Number | 1942758487
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Entity Type | Organization
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Legal Business Name | APPLEGATE RECOVERY OF MONROE, LLC
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 3001 ARMAND ST STE A
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City | MONROE
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State | LA
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Zip | 71201-3761
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Country | US
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Telephone | 318-600-3687
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Fax | 318-600-3698
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Provider Business Mailing Address
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Address Line | 1605 BENTON RD STE D
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City | BOSSIER CITY
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State | LA
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Zip | 71111-3579
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Country | US
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Telephone | 318-742-0500
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Fax | 318-742-0588
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | KATHRYN THOMAS
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Credential | LPC
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Telephone | 318-742-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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