Organization
SOUTHERN PSYCHIATRIC & MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREALON LIRETTE (PMHNP)
(985) 635-6943
Entity
Organization
Contact information
Practice address
8175 PARK AVE, HOUMA, LA 70364-3438
(985) 635-6943
Mailing address
PO BOX 1536, MANDEVILLE, LA 70470-1536
(985) 635-6943
(985) 231-6733
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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