Basic Information
| Provider Information | |||||||||
| NPI: | 1144815119 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WE CARE EDUCATIONAL RESURCES OF LA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3804 SPENCER ST | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713022242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184843913 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3804 SPENCER ST | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713022242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184843913 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2021 | ||||||||
| LastUpdateDate: | 08/11/2022 | ||||||||
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| AuthorizedOfficialLastName: | MILLS | ||||||||
| AuthorizedOfficialFirstName: | VERNON | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | LICENSED ADDICTION COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 3184843913 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | SR. | ||||||||
| AuthorizedOfficialCredential: | 713 LAC, CCS 017 | ||||||||
| NPICertificationDate: | 08/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor |
ID Information
| ID | Type | State | Issuer | Description | 713 | 01 | LA | STATE OF LOUISIANA ADDICTIVE DISORDER REGULATORY AUTHORITY | OTHER |