Provider Demographics
NPI:1013314012
Name:360 MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:360 MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:337-256-3129
Mailing Address - Street 1:1614 EAST MAIN STREET SUITE D
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560
Mailing Address - Country:US
Mailing Address - Phone:337-256-5917
Mailing Address - Fax:
Practice Address - Street 1:1614 EAST MAIN STREET SUITE D
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560
Practice Address - Country:US
Practice Address - Phone:337-256-5917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health