Provider Demographics
NPI:1598975161
Name:ADDICTION,EDUCATION,EVALUATION, AND TREATMENT
Entity Type:Organization
Organization Name:ADDICTION,EDUCATION,EVALUATION, AND TREATMENT
Other - Org Name:AEET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SID
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:SAC
Authorized Official - Phone:985-516-3540
Mailing Address - Street 1:450 NORTH CAUSEWAY
Mailing Address - Street 2:SUITEB
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448
Mailing Address - Country:US
Mailing Address - Phone:985-516-3540
Mailing Address - Fax:
Practice Address - Street 1:450 NORTH CAUSEWAY
Practice Address - Street 2:SUITEB
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448
Practice Address - Country:US
Practice Address - Phone:985-516-3540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA325261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========OtherTAX ID NUMBER