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General NPI Number Information
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NPI Number | 1962210492
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Entity Type | Organization
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Legal Business Name | RICELAND RECOVERY, LLC
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 3405 MOSS ST
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City | LAFAYETTE
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State | LA
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Zip | 70507-6113
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Country | US
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Telephone | 225-377-4306
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Fax |
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Provider Business Mailing Address
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Address Line | 820 E 4TH ST
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City | CROWLEY
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State | LA
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Zip | 70526-5310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LATT SOILEAU
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Credential |
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Telephone | 337-263-3006
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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 |
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License Number State |
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