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General NPI Number Information
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NPI Number | 1265198543
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Entity Type | Organization
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Legal Business Name | ADDICTION SPECIALISTS
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Dates
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Enumeration Date | 11/11/2021
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 4330 LOVELAND ST
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City | METAIRIE
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State | LA
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Zip | 70006-4176
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Country | US
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Telephone | 888-488-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 4330 LOVELAND ST
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City | METAIRIE
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State | LA
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Zip | 70006-4176
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Country | US
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Telephone | 888-488-5253
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ROY VIGER
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Credential |
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Telephone | 504-756-9242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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