Provider Demographics
NPI:1619318862
Name:CHOICES OF LOUISIANA, ALEXANDRIA LLC
Entity Type:Organization
Organization Name:CHOICES OF LOUISIANA, ALEXANDRIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELSIE
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN,LAC,CRT
Authorized Official - Phone:225-450-3340
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:BRITTANY
Mailing Address - State:LA
Mailing Address - Zip Code:70718-0310
Mailing Address - Country:US
Mailing Address - Phone:225-450-3340
Mailing Address - Fax:
Practice Address - Street 1:2116 N BOLTON AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-4405
Practice Address - Country:US
Practice Address - Phone:318-445-1216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LASA0003769261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone