Organization
DEPARTMENT OF HEALTH AND HOSPITALS
Active
Other names
Monroe Behavioral Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK DEBORD LCSW (OBH REGIONAL ADMINISTRATOR)
(318) 362-3270
Entity
Organization
Contact information
Practice address
4800 S GRAND ST, MONROE, LA 71202-6412
(318) 362-3339
(318) 362-3336
Mailing address
4800 S GRAND ST, MONROE, LA 71202-6412
(318) 362-3339
(318) 362-3336
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
015
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B6214
BCBSLA
LA
Enumeration date
04/20/2006
Last updated
05/10/2011
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