Healthcare Provider Details

I. General information

NPI: 1437196946
Provider Name (Legal Business Name): DEPARTMENT OF HEALTH AND HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19404 N 10TH ST
COVINGTON LA
70433-8892
US

IV. Provider business mailing address

19404 N 10TH ST
COVINGTON LA
70433-8892
US

V. Phone/Fax

Practice location:
  • Phone: 985-871-1380
  • Fax: 985-871-1387
Mailing address:
  • Phone: 985-871-1380
  • Fax: 985-871-1387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number233
License Number StateLA

VIII. Authorized Official

Name: MS. ROBIN JOUBERT
Title or Position: CLINIC MANAGER
Credential: LCSW
Phone: 985-871-1380