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Organization

HEALTHY MINDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELA NICHOLS PHD (PROGRAM DIRECTOR)
(318) 239-3890
Entity
Organization

Contact information

Practice address
209 W JEFFERSON AVE, BASTROP, LA 71220-4543
(318) 239-3890
(318) 239-3891
Mailing address
209 W JEFFERSON AVE, BASTROP, LA 71220-4543
(318) 239-3890
(318) 239-3891

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
5132
LA
251S00000X
Community/Behavioral Health Agency
Primary
5905
LA

Other

Enumeration date
08/05/2015
Last updated
08/05/2015
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