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NPI Code Detail

MEDICARE: BETHEA AND MCNEAL BEHAVIORAL HEALTH CENTER LLC

MEDICARE: BETHEA AND MCNEAL BEHAVIORAL HEALTH CENTER 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1376088690
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETHEA AND MCNEAL BEHAVIORAL HEALTH CENTER LLC
Provider Business Mailing Address
First Line : 1803 EVELYN DR
Second Line :
City : BASTROP
State : LA
Zip : 71220-2224
Country : US
Telephone Number : 318-267-5190
Fax Number :
Provider Business Practice Location Address
First Line : 651 E MADISON AVE
Second Line :
City : BASTROP
State : LA
Zip : 71220-3833
Country : US
Telephone Number : 318-267-5190
Fax Number :
Authorized Official
Title or Position : CO-OWNER
Name : ARIELLE L MCNEAL
Credential :
Telephone Number : 318-509-9695
Provider Enumeration Date : 12/21/2016
Last Update Date : 12/21/2016

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