Provider Demographics
NPI:1831854868
Name:THERAPEUTIC SOLUTIONS OF CENTRAL LOUISIANA LLC
Entity type:Organization
Organization Name:THERAPEUTIC SOLUTIONS OF CENTRAL LOUISIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON-CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-485-9149
Mailing Address - Street 1:405 SKYBLUE DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-9002
Mailing Address - Country:US
Mailing Address - Phone:318-485-9149
Mailing Address - Fax:
Practice Address - Street 1:5401 JACKSON ST STE B
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2595
Practice Address - Country:US
Practice Address - Phone:318-265-7134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty