360 Recovery Group LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Baton Rouge, LA
NPI 1033738562 · NPPES record last updated Jul 18, 2023
Key facts
- NPI
- 1033738562
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- 360 RECOVERY GROUP LLC
- Practice address
- 6220 Florida Blvd Ste D
Baton Rouge, LA 70806-4556 - Phone
- (225) 810-3885
- Fax
- (833) 810-3885
- NPI assigned
- Apr 14, 2020
- Organization subpart
- No
Authorized official
- Name
- Jaliah Pabon
- Title
- Administrator
- Phone
- (225) 810-3885
Practitioners 10
-
Carol Darr, PMHNP
-
Tanisha M Esters, NP
-
Chandra M Katta, M.D.
-
Danielle Marie Levy, M.D.
-
Juan Smith, LCSW
-
Monique Pierre Williams, DNP, APRN, FNP/PMHNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200528002125 | LA | Part a Provider - Community Mental Health Center | 5991126047 | Practice locations: Baton Rouge, LA |
National Provider Directory
Locations
4184 North Blvd
Baton Rouge, LA 70806
Phone (225) 218-5647
6220 Florida Blvd
Ste D
Baton Rouge, LA 70806
Phone (225) 810-0058
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
6220 Florida Blvd Ste D
Baton Rouge, LA 70806-4556
Mailing address
6220 Florida Blvd Ste D
Baton Rouge, LA 70806-4556
Phone (225) 810-3885
Other names
- NA
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- 360Care Audiology of Louisiana LLC
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All providers in Baton Rouge, LA · Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.