Organization
MIIBOSO CONSULTANTS
Active
Other names
GENESIIS BEHAVIORAL HEALTH, THE GENESIIS GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARMAINE STITH LPC-S (CEO)
(225) 993-1535
Entity
Organization
Contact information
Practice address
2944 RAY WEILAND DR, BAKER, LA 70714-3250
(225) 993-1535
Mailing address
2944 RAY WEILAND DR, BAKER, LA 70714-3250
(225) 993-1535
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3594
LA
101YM0800X
Mental Health Counselor
3594
LA
101YP1600X
Pastoral Counselor
3594
LA
Other
Enumeration date
12/21/2017
Last updated
10/18/2024
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