Provider Demographics
NPI:1790273654
Name:STRIVING 4 EXCELLENCE BEHAVIORAL HEALTHCARE, LLC
Entity Type:Organization
Organization Name:STRIVING 4 EXCELLENCE BEHAVIORAL HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-597-7291
Mailing Address - Street 1:12090 S HARRELLS FERRY RD STE L
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2470
Mailing Address - Country:US
Mailing Address - Phone:225-289-6891
Mailing Address - Fax:225-289-4487
Practice Address - Street 1:12090 S HARRELLS FERRY RD STE L
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2470
Practice Address - Country:US
Practice Address - Phone:225-289-6891
Practice Address - Fax:225-289-4487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA22003783879101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty