Organization
SEASIDE BEHAVIORAL CENTER, LLC
Active
Parent organization
SEASIDE BEHAVIORAL CENTER, LLC
Other names
SBC Physician Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
SEASIDE BEHAVIORAL CENTER, LLC
Authorized official
JOHNNY D. LANCASTER (CFO)
(318) 841-2619
Entity
Organization
Contact information
Practice address
4201 WOODLAND DRIVE, NEW ORLEANS, LA 70131
(504) 393-4223
(504) 267-5692
Mailing address
101 FEU FOLLET DRIVE, SUITE 100, LAFAYETTE, LA 70503
(337) 234-8455
(337) 234-8482
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2203781725
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2700073
—
LA
Enumeration date
09/14/2015
Last updated
09/14/2015
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