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NPI Code Detail

MEDICARE: MOTIVATE WELLNESS BEHAVIORAL & RELATIONSHIP HEALTH SERVICES, LLC

MEDICARE: MOTIVATE WELLNESS BEHAVIORAL & RELATIONSHIP 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
1261QM0855XAdolescent and Children Mental Health Clinic/Center
2261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1417502113
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOTIVATE WELLNESS BEHAVIORAL & RELATIONSHIP HEALTH SERVICES, LLC
Provider Business Mailing Address
First Line : 1901 MANHATTAN BLVD BLDG D
Second Line :
City : HARVEY
State : LA
Zip : 70058-3583
Country : US
Telephone Number : 504-372-6268
Fax Number : 800-392-3159
Provider Business Practice Location Address
First Line : 1901 MANHATTAN BLVD BLDG D
Second Line :
City : HARVEY
State : LA
Zip : 70058-3583
Country : US
Telephone Number : 504-372-6268
Fax Number : 800-392-3159
Authorized Official
Title or Position : CEO
Name : MS. LEDORA YERKS
Credential : M.ED, LPC, NCC
Telephone Number : 504-372-6268
Provider Enumeration Date : 08/08/2019
Last Update Date : 08/08/2019

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