Organization
THERAPEUTIC BEHAVIORAL SERVICESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DURRELL JEFFERY (C.E.O.)
(940) 735-0604
Entity
Organization
Contact information
Practice address
605 SILVER LILLY LN, MARRERO, LA 70072-1426
(940) 735-0604
Mailing address
605 SILVER LILLY LN, MARRERO, LA 70072-1426
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
—
LA
302R00000X
Health Maintenance Organization
Primary
—
LA
305R00000X
Preferred Provider Organization
—
LA
305S00000X
Point of Service
—
LA
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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