Marlo Anderson

Individual provider Active NPI Community/Behavioral Health Agency · Baker, LA

NPI 1962867960 · NPPES record last updated Dec 18, 2015

Key facts

NPI
1962867960
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
273056931 (LA)
Practice address
13888 Plank Rd
Baker, LA 70714-4929
Phone
(225) 636-2638
Fax
(225) 775-5068
NPI assigned
Dec 18, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Gaines and Faith LLC Community/Behavioral Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 273056931 LA Yes

Addresses

Primary practice location

13888 Plank Rd
Baker, LA 70714-4929

Mailing address

13888 Plank Rd
Baker, LA 70714-4929
Phone (225) 636-2638

Other providers in Baker, LA

All providers in Baker, LA · Community/Behavioral Health Agency in Louisiana

Sources for this page

Verify at the official NPI Registry.