Healthcare Provider Details

I. General information

NPI: 1821563552
Provider Name (Legal Business Name): ADDICTION COUNSELING AND EDUCATIONAL RESOURCES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9431 COMMON ST
BATON ROUGE LA
70809-1435
US

IV. Provider business mailing address

115 CHRISTIAN LN
SLIDELL LA
70458-1350
US

V. Phone/Fax

Practice location:
  • Phone: 985-690-6622
  • Fax: 985-690-6662
Mailing address:
  • Phone: 985-690-6622
  • Fax: 985-690-6662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MORRIS C. HAWKINS
Title or Position: CEO
Credential: RN
Phone: 985-690-6622