Organization
PROVISION REHAB, LLC
Active
Other names
PROVISION REHAB
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEADRIAN ANDRELL ALEXANDER-FICKLIN (CEO)
(318) 238-4030
Entity
Organization
Contact information
Practice address
113 SOUTH DR, NATCHITOCHES, LA 71457-5039
(318) 238-4030
Mailing address
113 SOUTH DR, NATCHITOCHES, LA 71457-5039
(318) 542-9367
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/23/2010
Last updated
02/08/2012
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