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NPI Code Detail

MEDICARE: BAYMARK HEALTH SERVICES OF LOUISIANA, INC.

MEDICARE: BAYMARK HEALTH SERVICES OF LOUISIANA, INC.
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
1261QM2800XMethadone Clinic
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1891341822
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAYMARK HEALTH SERVICES OF LOUISIANA, INC.
Provider Business Mailing Address
First Line : 1720 LAKEPOINTE DR STE 117
Second Line :
City : LEWISVILLE
State : TX
Zip : 75057-6425
Country : US
Telephone Number : 214-379-3300
Fax Number : 214-853-9018
Provider Business Practice Location Address
First Line : 615 PRIDE DR
Second Line :
City : HAMMOND
State : LA
Zip : 70401-9523
Country : US
Telephone Number : 214-379-3300
Fax Number :
Authorized Official
Title or Position : VP, TREASURER
Name : BRUCE JARVIE
Credential :
Telephone Number : 214-379-3300
Provider Enumeration Date : 08/15/2019
Last Update Date : 07/29/2024

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