Organization
DEPARTMENT OF HEALTH AND HOSPITALS
Active
Other names
Jonesboro Behavioral Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DEBORD LCSW (REGIONAL ADMINISTRAT)
(318) 362-3270
Entity
Organization
Contact information
Practice address
602 E GEORGIA AVE, RUSTON, LA 71270-3931
(318) 251-4125
(318) 251-5000
Mailing address
2513 FERRAND ST, MONROE, LA 71201-3210
(318) 362-3270
(318) 362-3268
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
100
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710571
—
LA
Enumeration date
01/30/2007
Last updated
07/23/2013
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