Provider Demographics
NPI:1003680901
Name:SALCEDO BEHAVIORAL HEALTH & CONSULTATION SERVICES LLC
Entity Type:Organization
Organization Name:SALCEDO BEHAVIORAL HEALTH & CONSULTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MENTAL HEALTH PROFESSIONA
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SALCEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-231-8022
Mailing Address - Street 1:1581 CAROL SUE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-5100
Mailing Address - Country:US
Mailing Address - Phone:985-231-8022
Mailing Address - Fax:
Practice Address - Street 1:1581 CAROL SUE AVE STE 202
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5100
Practice Address - Country:US
Practice Address - Phone:985-231-8022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-10
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)