Provider Demographics
NPI:1609008788
Name:G&R MENTAL HEALTH ASSOCIATES, INC.
Entity type:Organization
Organization Name:G&R MENTAL HEALTH ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP,PMHNP,BC
Authorized Official - Phone:318-607-4665
Mailing Address - Street 1:20346 DE CHENE DR
Mailing Address - Street 2:UNIT 21
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-7249
Mailing Address - Country:US
Mailing Address - Phone:318-607-4665
Mailing Address - Fax:225-271-4793
Practice Address - Street 1:20346 DE CHENE DR
Practice Address - Street 2:UNIT 21
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-7249
Practice Address - Country:US
Practice Address - Phone:318-607-4665
Practice Address - Fax:225-271-4793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04081363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty