Provider Demographics
NPI:1093726978
Name:STC ADDICTION WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:STC ADDICTION WELLNESS CENTER, INC.
Other - Org Name:ST. CHRISTOPHERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BADEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-387-1611
Mailing Address - Street 1:150 CORA DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-4201
Mailing Address - Country:US
Mailing Address - Phone:225-387-1611
Mailing Address - Fax:225-343-5300
Practice Address - Street 1:150 CORA DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-4201
Practice Address - Country:US
Practice Address - Phone:225-387-1611
Practice Address - Fax:225-343-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
276400000X
LA203324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit