Provider Demographics
NPI:1033588793
Name:CENTER FOR BEHAVIORAL HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:CENTER FOR BEHAVIORAL HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELLE
Authorized Official - Middle Name:MONICA
Authorized Official - Last Name:ESCOUSSE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:985-276-0349
Mailing Address - Street 1:302 RICHMOND ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-3942
Mailing Address - Country:US
Mailing Address - Phone:985-516-6684
Mailing Address - Fax:
Practice Address - Street 1:302 RICHMOND ST
Practice Address - Street 2:SUITE A
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3942
Practice Address - Country:US
Practice Address - Phone:985-516-6684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health