Provider Demographics
NPI:1790160869
Name:BEHAVIORAL HEALTH SOLUTIONS OF LOUISIANA, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH SOLUTIONS OF LOUISIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWANE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:985-652-7840
Mailing Address - Street 1:501 RUE DE SANTE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-5400
Mailing Address - Country:US
Mailing Address - Phone:985-652-7840
Mailing Address - Fax:985-652-7839
Practice Address - Street 1:501 RUE DE SANTE
Practice Address - Street 2:SUITE 4
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-5400
Practice Address - Country:US
Practice Address - Phone:985-652-7840
Practice Address - Fax:985-652-7839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty