Organization
MATTHEW 2540 CORPORATION
Active
Other names
Nepenthe House
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY HIGGINBOTHAM BSW, MSSA (EXECUTIVE DIRECTOR)
(337) 439-3061
Entity
Organization
Contact information
Practice address
1414 MARTHA ST, LAKE CHARLES, LA 70601-2440
(337) 439-3061
(337) 439-4279
Mailing address
1414 MARTHA ST, LAKE CHARLES, LA 70601-2440
(337) 439-3061
(337) 439-4279
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
184
LA
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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