Provider Demographics
NPI:1174847594
Name:BATON ROUGE AREA ALCOHOL & DRUG CENTER, INC.
Entity Type:Organization
Organization Name:BATON ROUGE AREA ALCOHOL & DRUG CENTER, INC.
Other - Org Name:BATON ROUGE DETOXIFICATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:MUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:225-389-3325
Mailing Address - Street 1:1819 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-3843
Mailing Address - Country:US
Mailing Address - Phone:225-389-3325
Mailing Address - Fax:225-389-5334
Practice Address - Street 1:1819 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-3843
Practice Address - Country:US
Practice Address - Phone:225-389-3325
Practice Address - Fax:225-389-5334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014261QR0405X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder