Provider Demographics
NPI:1770911109
Name:LEI BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:LEI BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUCKY
Authorized Official - Middle Name:
Authorized Official - Last Name:IHENYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-491-5382
Mailing Address - Street 1:4300 S I 10 SERVICE RD W STE 215
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-7436
Mailing Address - Country:US
Mailing Address - Phone:504-301-9990
Mailing Address - Fax:504-265-9370
Practice Address - Street 1:4300 S I 10 SERVICE RD W STE 215
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-7436
Practice Address - Country:US
Practice Address - Phone:504-301-9990
Practice Address - Fax:504-265-9370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
LA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)