Organization
HOLISTIC EDUCATIONAL REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LASHUN DOYLE CAMPBELL (MANAGER)
15049156596
Entity
Organization
Contact information
Practice address
1799 STUMPF BLVD, BLDG 7 STE 7, TERRYTOWN, LA 70056-3950
(504) 915-6596
Mailing address
1799 STUMPF BLVD, BLDG 7 STE 7, TERRYTOWN, LA 70056-3950
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
12455
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194883
—
LA
Enumeration date
04/19/2007
Last updated
02/09/2009
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