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
Update your record
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