Provider Demographics
NPI:1114627072
Name:STONEBRIDGE HEALTH SYSTEMS, LLC
Entity Type:Organization
Organization Name:STONEBRIDGE HEALTH SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TRAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-439-8111
Mailing Address - Street 1:2837 ERNEST ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8785
Mailing Address - Country:US
Mailing Address - Phone:337-439-8111
Mailing Address - Fax:337-542-4110
Practice Address - Street 1:2837 ERNEST ST STE A
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8785
Practice Address - Country:US
Practice Address - Phone:337-439-8111
Practice Address - Fax:337-542-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital