Provider Demographics
NPI:1003035825
Name:VERMILION BEHAVIORAL HEALTH CENTER
Entity type:Organization
Organization Name:VERMILION BEHAVIORAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:337-643-7333
Mailing Address - Street 1:710 N FOOTE AVE
Mailing Address - Street 2:
Mailing Address - City:KAPLAN
Mailing Address - State:LA
Mailing Address - Zip Code:70548-3030
Mailing Address - Country:US
Mailing Address - Phone:337-643-7333
Mailing Address - Fax:337-643-7338
Practice Address - Street 1:710 N FOOTE AVE
Practice Address - Street 2:
Practice Address - City:KAPLAN
Practice Address - State:LA
Practice Address - Zip Code:70548-3030
Practice Address - Country:US
Practice Address - Phone:337-643-7333
Practice Address - Fax:337-643-7338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA194666Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER