Organization
PRISM II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE BIENVENU OT (PARTNER/MANAGING OPERATOR)
(318) 238-2810
Entity
Organization
Contact information
Practice address
1005 FISHER RD, MANY, LA 71449-3833
(318) 256-0800
(318) 256-0801
Mailing address
1005 FISHER RD, MANY, LA 71449-3833
(318) 256-0800
(318) 256-0801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1362630
—
LA
Enumeration date
04/14/2010
Last updated
04/14/2010
Update your record
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