Provider Demographics
NPI:1114536935
Name:BORRIS, ANJELLICA MAR'CHE
Entity type:Individual
Prefix:
First Name:ANJELLICA
Middle Name:MAR'CHE
Last Name:BORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12628 HOOPER RD STE C
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818-3527
Mailing Address - Country:US
Mailing Address - Phone:225-650-9489
Mailing Address - Fax:
Practice Address - Street 1:7110 NEW FOREST PKWY APT 723
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-2184
Practice Address - Country:US
Practice Address - Phone:225-650-9489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)