Organization
M DIOR BEHAVIOR HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DEMETRA HENDERSON (MANAGER)
(972) 505-6087
Entity
Organization
Contact information
Practice address
548 LAPALCO BLVD, GRETNA, LA 70056-7305
(504) 202-5739
Mailing address
548 LAPALCO BLVD, GRETNA, LA 70056-7305
(504) 202-5739
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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