Provider Demographics
NPI:1033167762
Name:DEPARTMENT OF HEALTH & HOSPITALS
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH & HOSPITALS
Other - Org Name:ALCOHOL AND DRUG UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUDREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-624-4100
Mailing Address - Street 1:PO BOX 1225
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70470-1225
Mailing Address - Country:US
Mailing Address - Phone:985-624-4121
Mailing Address - Fax:985-624-4123
Practice Address - Street 1:23664 CARDINAL COVE
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448
Practice Address - Country:US
Practice Address - Phone:985-624-4121
Practice Address - Fax:985-624-4123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA32324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility