Organization
AVENUE PARC
Active
Other names
Avenue Parc
Organization subpart
No
Provider details
NPI number
Authorized official
KYJUANA MOSES (CEO)
(225) 287-4146
Entity
Organization
Contact information
Practice address
646 N FOSTER DR STE B, BATON ROUGE, LA 70806-1887
(225) 287-4146
Mailing address
950 EAGLES LANDING PKWY STE 237, STOCKBRIDGE, GA 30281-7343
(225) 287-4146
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/20/2023
Last updated
04/03/2024
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