# PREVENTION CENTERS OF AMERICA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336488113
- **Authorized official:** NITIN MALLA (AGENT)
- **Authorized official phone:** (337) 446-2928

## Contact information

- **Practice address:** 1830 BERTRAND DR, SUITE 61427, LAFAYETTE, LA 70596-5001
- **Practice address phone:** (337) 446-2928
- **Mailing address:** 1830 BERTRAND DR, SUITE 61427, LAFAYETTE, LA 70596-5001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/13/2013
- **Last updated:** 02/13/2013