Basic Information
| Provider Information | |||||||||
| NPI: | 1336500743 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALL PRO BEHAVIORAL HEALTH SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 332 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | THIBODAUX | ||||||||
| State: | LA | ||||||||
| PostalCode: | 703015420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043141737 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1340 W TUNNEL BLVD STE 230 | ||||||||
| Address2: | |||||||||
| City: | HOUMA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043141737 | ||||||||
| FaxNumber: | 9852311377 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2016 | ||||||||
| LastUpdateDate: | 09/06/2018 | ||||||||
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| AuthorizedOfficialLastName: | VERDIN | ||||||||
| AuthorizedOfficialFirstName: | SADE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5043141737 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 2203783561 | LA | Y | Agencies | Community/Behavioral Health |
No ID Information.