Provider Demographics
NPI:1124273214
Name:CDJ REHABILITATION SERVICES, LLC
Entity type:Organization
Organization Name:CDJ REHABILITATION SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:D
Authorized Official - Last Name:JEANBATISTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT, LAC, CCGC
Authorized Official - Phone:337-394-8515
Mailing Address - Street 1:111 E CLAIBORNE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARTINVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70582-4503
Mailing Address - Country:US
Mailing Address - Phone:337-394-8515
Mailing Address - Fax:337-367-2088
Practice Address - Street 1:111 E CLAIBORNE ST
Practice Address - Street 2:
Practice Address - City:SAINT MARTINVILLE
Practice Address - State:LA
Practice Address - Zip Code:70582-4503
Practice Address - Country:US
Practice Address - Phone:337-394-8515
Practice Address - Fax:337-367-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2752101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty