Organization Name: | BIOBEHAVIORAL MEDICINE COMPANY, LLC |
NPI Number: | 1306020698 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALPHONSE KENISON ROY (MEDICAL DIRECTOR) |
Mailing Address: | 4933 Wabash St Metairie |
State: | LA US |
Postal Code: | 700011031 |
Phone Number: | 5047802766 |
Fax Number: | 5047809699 |
NPI Enumeration Date: | 12/21/2007 |
NPI Last Update Date: | 02/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | MD012078 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |