MEDICARE: DUSON MENTAL 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1740293331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUSON MENTAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	1530 HIGHWAY 90 W
Second Line	:
City	:	JENNINGS
State	:	LA
Zip	:	70546-4022
Country	:	US
Telephone Number	:	337-984-8355
Fax Number	:	337-984-8485

Provider Business Practice Location Address
First Line	:	1450 RIDGE ROAD
Second Line	:
City	:	DUSON
State	:	LA
Zip	:	70529
Country	:	US
Telephone Number	:	337-984-8355
Fax Number	:	337-984-8485

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RONNIE CALLAIS
Credential	:
Telephone Number	:	337-984-8355

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	08/22/2020

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Directions to “DUSON MENTAL HEALTH SERVICES LLC ” Practice Location

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