NPI 1104376342

Fphsa

Organisation Substance Abuse Rehabilitation Facility Mandeville, LA

Practice location

Address: 23515 Highway 190, Mandeville, LA 70448-7334
Phone: (985) 624-4100
Fax: (985) 624-4123
Mailing address: PO Box 37, Mandeville, LA 70470-0037

Authorised official

Name: Nadine Faciane
Title: Program Director
Phone: (985) 624-4100

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 960733 (LA)

Other Substance Abuse Rehabilitation Facility providers in Louisiana →

Registry record

NPI: 1104376342
Entity type: Organization
NPI issued: 12 Oct 2016
Record last updated: 12 Oct 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.