Provider Demographics
NPI:1790490068
Name:MONCEAUX HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:MONCEAUX HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:CLAIRE MILLER
Authorized Official - Last Name:MONCEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-580-0671
Mailing Address - Street 1:1025 LILLY RD
Mailing Address - Street 2:
Mailing Address - City:IOTA
Mailing Address - State:LA
Mailing Address - Zip Code:70543-3522
Mailing Address - Country:US
Mailing Address - Phone:337-580-0671
Mailing Address - Fax:
Practice Address - Street 1:124 TOWER RD
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2211
Practice Address - Country:US
Practice Address - Phone:337-399-2067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1588297303Medicaid
LA1104459387Medicaid