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General NPI Number Information
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NPI Number | 1548538804
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Entity Type | Organization
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Legal Business Name | CENLA CHEMICAL DEPENDENCY COUNCIL, INC
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | LINCOLN STREET UNIT 24 CLSH
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City | PINEVILLE
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State | LA
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Zip | 71360-0000
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Country | US
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Telephone | 318-484-6778
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Fax | 318-484-6502
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Provider Business Mailing Address
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Address Line | PO BOX 4582
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City | PINEVILLE
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State | LA
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Zip | 71361-4582
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Country | US
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Telephone | 318-484-6778
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Fax | 318-484-6502
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. KATHY PFLIPSEN
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Credential |
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Telephone | 318-484-6778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 214
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License Number State | LA
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