Organization
CYPRESS GROVE BEHAVIORAL HEALTH LLC
Active
Other names
Meridian Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES SMITH (CHIEF ADMINISTRATIVE OFFICER)
(612) 326-7575
Entity
Organization
Contact information
Practice address
414 PINE ST, MONROE, LA 71201-6228
(318) 699-8819
Mailing address
550 MAIN STREET, SUITE 250, CONTRACTING/CREDENTIALING, NEW BRIGHTON, MN 55112
(612) 326-7575
(612) 454-2430
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159664125
—
AR
05
—
1709581
—
LA
Enumeration date
08/10/2006
Last updated
07/16/2020
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