# BIOACTIVE INFUSION & WELLNESS, LLC

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

## Provider details

- **NPI number:** 1770213217
- **Authorized official:** KIMBERLY GATTE FNPC (CO-OWNER)
- **Authorized official phone:** (337) 581-7009

## Contact information

- **Practice address:** 100 W LOUISIANA AVE, RAYNE, LA 70578-5912
- **Practice address phone:** (337) 581-7009
- **Mailing address:** 100 W LOUISIANA AVE, RAYNE, LA 70578-5912
- **Mailing address phone:** (337) 581-7009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/16/2022
- **Last updated:** 12/26/2023