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General NPI Number Information
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NPI Number | 1699227355
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Entity Type | Organization
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Legal Business Name | CHRIST ASSOCIATION
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 700 S 6TH ST
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City | MONROE
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State | LA
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Zip | 71202-2226
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Country | US
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Telephone | 707-341-0771
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Fax |
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Provider Business Mailing Address
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Address Line | 700 S 6TH ST P O BOX 773
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City | MONROE
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State | LA
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Zip | 71202-2226
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Country | US
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Telephone | 707-341-0771
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DAVID HARTFIELD-DYELS
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Credential | CA2
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Telephone | 707-341-0771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 251S00000X
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License Number State | CA
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