Healthcare Provider Details

I. General information

NPI: 1215988241
Provider Name (Legal Business Name): DEPARTMENT OF HEALTH AND HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23260 GREENWELL SPRINGS RD
GREENWELL SPRINGS LA
70739-6031
US

IV. Provider business mailing address

PO BOX 244
GREENWELL SPRINGS LA
70739-0244
US

V. Phone/Fax

Practice location:
  • Phone: 225-262-2474
  • Fax: 225-262-3551
Mailing address:
  • Phone: 225-262-2474
  • Fax: 225-262-3551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number263
License Number StateLA

VIII. Authorized Official

Name: MRS. ALICE ROELING
Title or Position: OAD INPATIENT FACILITY MANAGER
Credential: LAC
Phone: 225-262-3559