Healthcare Provider Details
I. General information
NPI: 1265670905
Provider Name (Legal Business Name): ACADIANA ADDICTION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/03/2009
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
156 CHOCTAW RD
SUNSET LA
70584-5415
US
IV. Provider business mailing address
156 CHOCTAW RD
SUNSET LA
70584-5415
US
V. Phone/Fax
- Phone: 337-233-1111
- Fax: 337-510-7026
- Phone: 337-233-1111
- Fax: 337-510-7026
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
CHRISTOPHER
HOWARD
Title or Position: VICE PRESIDENT & SECRETARY
Credential:
Phone: 615-861-6000