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Organization
DEPARTMENT OF HEALTH AND HOSPITALS
Active
Organization
DEPARTMENT OF HEALTH AND HOSPITALS
Active
Other names
South Lafourche Mental Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENT ST. GERMAIN LPC, LMFT (MENTAL HEALTH REGIONAL DIRECTOR)
(985) 857-3673
Entity
Organization
Contact information
Practice address
127 E 123RD ST, GALLIANO, LA 70354-4223
(985) 632-2175
(985) 632-8651
Mailing address
127 E 123RD ST, GALLIANO, LA 70354-4223
(985) 632-2175
(985) 632-8651
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
86
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710270
—
LA
Enumeration date
03/24/2008
Last updated
11/12/2008
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