Organization
DEPARTMENT OF HEALTH AND HOSPITALS
Active
Other names
DR. JOSEPH H. TYLER, JR. BEHAVIORAL HEALTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YANCEY MIRE LPC (BEHAVIORAL HEALTH DIRECTOR)
(337) 262-4100
Entity
Organization
Contact information
Practice address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
(337) 262-4117
Mailing address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
(337) 262-4117
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
005
LA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
176
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710032
—
LA
01
—
5HD26
MEDICARE PTAN
LA
Enumeration date
01/23/2007
Last updated
09/19/2013
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