Organization
PREMIER SERVICES OF LOUISIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LANISE CLEMONS (ADMINISTRATOR)
(225) 930-0051
Entity
Organization
Contact information
Practice address
921 LOBDELL, BATON ROUGE, LA 70806
(225) 930-0051
(225) 930-0076
Mailing address
921 LOBDELL, BATON ROUGE, LA 70806
(225) 930-0051
(225) 930-0076
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1371548
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1371548
—
LA
Enumeration date
05/22/2009
Last updated
05/22/2009
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