Organization
SUPPORTIVE CARE OF LOUISIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL LICHTSCHEIN (PRESIDENT)
(718) 298-4375
Entity
Organization
Contact information
Practice address
3867 PLAZA TOWER DR FL 1, BATON ROUGE, LA 70816-4378
(718) 298-4375
Mailing address
27 RANDOLPH RD, HOWELL, NJ 07731-8611
(718) 298-4372
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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