# BREALON LIRETTE LLC

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

## Provider details

- **NPI number:** 1578046090
- **Authorized official:** BREALON M LIRETTE APRN (OWNER)
- **Authorized official phone:** (985) 804-0678

## Contact information

- **Practice address:** 242 WOODWIND DR, HOUMA, LA 70360-3996
- **Practice address phone:** (337) 643-8424
- **Practice address fax:** (337) 643-8407
- **Mailing address:** 242 WOODWIND DR, HOUMA, LA 70360-3996
- **Mailing address phone:** (337) 643-8424
- **Mailing address fax:** (337) 643-8407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 09/11/2018
- **Last updated:** 04/27/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2456067 | — | LA |