Organization
GRAVES LLC
Active
Other names
Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER LAINE GRAVES (DIRECTOR OF OPERATIONS)
(225) 771-8251
Entity
Organization
Contact information
Practice address
3888 S SHERWOOD FOREST BLVD STE F, BATON ROUGE, LA 70816-4400
(225) 771-8251
(225) 771-8253
Mailing address
4354 S SHERWOOD FOREST BLVD, STE 120, BATON ROUGE, LA 70816-4476
(225) 771-8251
(225) 771-8253
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
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
600909016
MAGELLAN OF LOUISIANA
LA
Enumeration date
03/03/2015
Last updated
06/29/2023
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