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Organization

PRISM II, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOE BIENVENU OT (PARTNER)
(318) 481-2148
Entity
Organization

Contact information

Practice address
740 KEYSER AVE, NATCHITOCHES, LA 71457-6037
(318) 214-0088
(318) 214-9009
Mailing address
740 KEYSER AVE, NATCHITOCHES, LA 71457-6037
(318) 214-0088
(318) 214-9009

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
05
1524069
LA
Enumeration date
03/15/2010
Last updated
03/15/2010
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