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General NPI Number Information
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NPI Number | 1699955815
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Entity Type | Organization
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Legal Business Name | COUNCIL ON ALCOHOLISM AND DRUG ABUSE OF NORTHWEST LOUISIANA
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 2000 FAIRFIELD AVENUE
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City | SHREVEPORT
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State | LA
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Zip | 71104
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Country | US
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Telephone | 318-222-8511
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Fax | 318-212-5565
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Provider Business Mailing Address
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Address Line | 2000 FAIRFIELD AVENUE
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City | SHREVEPORT
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State | LA
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Zip | 71104
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Country | US
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Telephone | 318-222-8511
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Fax | 318-212-5565
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JANET MILLER
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Credential |
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Telephone | 318-222-8511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 238
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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