1528156510 NPI number — THERAPY CENTER OF AVOYELLES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528156510 NPI number — THERAPY CENTER OF AVOYELLES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPY CENTER OF AVOYELLES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528156510
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1170
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARKSVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71351-1170
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-253-8846
Provider Business Mailing Address Fax Number:
318-253-8875

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5435 HIGHWAY 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARKSVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-253-8846
Provider Business Practice Location Address Fax Number:
318-253-8875
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LOGAN
Authorized Official First Name:
MITZI
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
318-253-8846

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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