Organization
COMMUNITY REHABILITATION CENTER, LLC
Active
Other names
Community Rehabilitation Center, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
EARNEST JEROME WYATT (OWNER)
(318) 503-6902
Entity
Organization
Contact information
Practice address
2414 FERRAND ST STE 1, MONROE, LA 71201-3249
(318) 325-0072
(318) 325-0070
Mailing address
2414 FERRAND ST STE 1, MONROE, LA 71201-3249
(318) 325-0072
(318) 325-0070
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
LA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/11/2008
Last updated
06/21/2023
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