# SOUTHEAST NEUROSCIENCE CENTER, LLC

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

## Provider details

- **NPI number:** 1366820367
- **Authorized official:** MS. STACY HENRY (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (985) 917-3007

## Contact information

- **Practice address:** 8120 MAIN ST, SUITE 400, HOUMA, LA 70360-3403
- **Practice address phone:** (985) 917-3007
- **Practice address fax:** (985) 917-3010
- **Mailing address:** PO BOX 4051, HOUMA, LA 70361-4051
- **Mailing address phone:** (985) 917-3001
- **Mailing address fax:** (985) 917-3007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/11/2015
- **Last updated:** 05/11/2015