Organization
SOUTHEAST NEUROSCIENCE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY HENRY (PRACTICE ADMINISTRATOR)
(985) 917-3007
Entity
Organization
Contact information
Practice address
8120 MAIN ST, SUITE 400, HOUMA, LA 70360-3403
(985) 917-3007
(985) 917-3010
Mailing address
PO BOX 4051, HOUMA, LA 70361-4051
(985) 917-3001
(985) 917-3007
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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