Organization
BOYS AND GIRLS VILLAGES FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAYANCE JOSEPH MATHIEU, JR. LPC (EXECUTIVE DIRECTOR)
(337) 436-7553
Entity
Organization
Contact information
Practice address
7378 HIGHWAY 90 E, LAKE CHARLES, LA 70615-4803
(337) 436-7553
(337) 436-8291
Mailing address
7378 HIGHWAY 90 E, LAKE CHARLES, LA 70615-4803
(337) 436-7553
(337) 436-8291
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
8998
LA
Other
Enumeration date
05/16/2012
Last updated
05/16/2012
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