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NPI Code Detail

MEDICARE: STC ADDICTION WELLNESS CENTER, INC.

MEDICARE: STC ADDICTION WELLNESS CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1276400000XSubstance Use Disorder Rehabilitation Hospital Unit
2324500000XSubstance Abuse Rehabilitation Facility203LA

General Provider Information

NPI Number : 1093726978
Entity Type Code : Organization
Provider Name (Legal Business Name) : STC ADDICTION WELLNESS CENTER, INC.
Provider Business Mailing Address
First Line : 150 CORA DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70815-4201
Country : US
Telephone Number : 225-387-1611
Fax Number : 225-343-5300
Provider Business Practice Location Address
First Line : 150 CORA DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70815-4201
Country : US
Telephone Number : 225-387-1611
Fax Number : 225-343-5300
Authorized Official
Title or Position : FINANCIAL OFFICE MANAGER
Name : ANGELA N BADEAUX
Credential :
Telephone Number : 225-387-1611
Provider Enumeration Date : 08/10/2006
Last Update Date : 02/07/2024

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