Organization
FELICIANAS' YOUTH OF DISTINCTION BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE SPANN GILMORE MA (ADMINISTRATIVE DIRECTOR)
(225) 244-7026
Entity
Organization
Contact information
Practice address
10105 PLANK RD STE A, CLINTON, LA 70722-3707
(225) 244-7026
(225) 244-7028
Mailing address
10105 PLANK RD STE A, CLINTON, LA 70722-3707
(225) 244-7026
(225) 244-7028
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600925226
—
LA
Enumeration date
03/28/2014
Last updated
03/28/2014
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