| Organization Name: | FUNDAMENTALS, LLC |
| NPI Number: | 1023262383 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COLETTE MELANCON (OWNER) |
| Mailing Address: | 60 Louis Prima Dr Suite A Covington |
| State: | LA US |
| Postal Code: | 704335903 |
| Phone Number: | 5044306116 |
| Fax Number: | 8663008753 |
| NPI Enumeration Date: | 11/12/2008 |
| NPI Last Update Date: | 01/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 3883 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |