Provider Demographics
NPI:1003372434
Name:ALLIANCE THERAPEUTIC GROUP LLC
Entity Type:Organization
Organization Name:ALLIANCE THERAPEUTIC GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:337-298-1380
Mailing Address - Street 1:5926 CAMERON ST UNIT 785
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-6034
Mailing Address - Country:US
Mailing Address - Phone:372-981-3803
Mailing Address - Fax:337-205-6191
Practice Address - Street 1:3419 NW EVANGELINE TRWY STE A-4
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-6241
Practice Address - Country:US
Practice Address - Phone:337-298-1380
Practice Address - Fax:337-205-6191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty