Organization
BAYOU MENTAL HEALTH OF ALEXANDRIA AND DERIDDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KNAKITA BAILEY (PRACTICE MANAGER)
(318) 623-5839
Entity
Organization
Contact information
Practice address
1605 MURRAY ST, SUITE 104, ALEXANDRIA, LA 71301-6890
(318) 623-5839
Mailing address
PO BOX 12726, ALEXANDRIA, LA 71315-2726
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MD201241
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1408034
—
LA
Enumeration date
03/22/2016
Last updated
03/22/2016
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