Organization
CYPRESS GROVE BEHAVIORAL HEALTH LLC
Active
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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