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NPI Code Detail

MEDICARE: DEPARTMENT OF HEALTH AND HOSPITALS

MEDICARE: DEPARTMENT OF HEALTH AND HOSPITALS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center3514LA

General Provider Information

NPI Number : 1023066230
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEPARTMENT OF HEALTH AND HOSPITALS
Provider Business Mailing Address
First Line : WASHINGTON PARISH ADAC
Second Line : 2106 AVENUE F
City : BOGALUSA
State : LA
Zip : 70427-5027
Country : US
Telephone Number : 985-732-6655
Fax Number : 985-732-6678
Provider Business Practice Location Address
First Line : WASHINGTON PARISH ADAC
Second Line : 2106 AVENUE F
City : BOGALUSA
State : LA
Zip : 70427-5027
Country : US
Telephone Number : 985-732-6655
Fax Number : 985-732-6678
Authorized Official
Title or Position : CLINICAL COORDINATOR
Name : JUDITH MICKENHEIM
Credential : RN
Telephone Number : 985-732-6655
Provider Enumeration Date : 05/04/2006
Last Update Date : 08/22/2020

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Directions to “DEPARTMENT OF HEALTH AND HOSPITALS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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