Organization
LILITH OF NATCHITOCHES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHELBY GENE AMONS JR. BSN, MSA (OWNER)
(318) 229-1175
Entity
Organization
Contact information
Practice address
103 LAKESIDE DR, NATCHITOCHES, LA 71457-7839
(318) 229-1175
Mailing address
103 LAKESIDE DR, NATCHITOCHES, LA 71457-7839
(318) 229-1175
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1857108-001
LA
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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