Provider Demographics
NPI:1144742248
Name:GUIDANCE FOR BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:GUIDANCE FOR BEHAVIORAL HEALTH, LLC
Other - Org Name:GUIDANCE FOR BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:T
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:318-582-5633
Mailing Address - Street 1:1204 STUBBS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5631
Mailing Address - Country:US
Mailing Address - Phone:318-582-5633
Mailing Address - Fax:318-582-5646
Practice Address - Street 1:1204 STUBBS AVE STE B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5631
Practice Address - Country:US
Practice Address - Phone:318-582-5633
Practice Address - Fax:318-582-5646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203783384251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2203783384Medicaid