Provider Demographics
NPI:1386088417
Name:AMENA HEALTHCARE GROUP LLC
Entity type:Organization
Organization Name:AMENA HEALTHCARE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-588-8111
Mailing Address - Street 1:5329 DIJON DR
Mailing Address - Street 2:107
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4378
Mailing Address - Country:US
Mailing Address - Phone:225-761-5070
Mailing Address - Fax:225-766-0773
Practice Address - Street 1:5329 DIJON DR
Practice Address - Street 2:STE 107
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4378
Practice Address - Country:US
Practice Address - Phone:225-761-5070
Practice Address - Fax:225-766-0773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services