Provider Demographics
NPI:1790323095
Name:MIND CARE, LLC
Entity Type:Organization
Organization Name:MIND CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN, PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CZUDEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-704-0640
Mailing Address - Street 1:304 BASS RD
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-6545
Mailing Address - Country:US
Mailing Address - Phone:337-353-2282
Mailing Address - Fax:
Practice Address - Street 1:108 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3521
Practice Address - Country:US
Practice Address - Phone:318-704-0640
Practice Address - Fax:318-704-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty