MEDICARE: EXCEPTIONAL BEHAVIORAL HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1235473133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEPTIONAL BEHAVIORAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	2439 MANHATTAN BLVD
Second Line	:	STE 308
City	:	HARVEY
State	:	LA
Zip	:	70058-5328
Country	:	US
Telephone Number	:	504-235-7778
Fax Number	:	504-366-5260

Provider Business Practice Location Address
First Line	:	2439 MANHATTAN BLVD
Second Line	:	STE 308
City	:	HARVEY
State	:	LA
Zip	:	70058-5328
Country	:	US
Telephone Number	:	504-235-7778
Fax Number	:	504-366-5260

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	TANIKA ANDREWS
Credential	:
Telephone Number	:	504-235-7778

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	06/23/2023

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