Individual
CRAIG COMANCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC
Contact information
Practice address
1010 N 9TH ST, MONROE, LA 71201-5513
(318) 789-9910
(318) 855-4372
Mailing address
1010 N 9TH ST, MONROE, LA 71201-5513
(318) 789-9910
(318) 855-4372
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
4199
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5077
STATE OF LOUISIANA ADDICTIVE DISORDER REGULATORY AUTHORITY
LA
Enumeration date
10/18/2018
Last updated
07/17/2025
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