Provider Demographics
NPI:1619109022
Name:SOUTH LOUISIANA ADDICTION TREATMENT SERVICES
Entity Type:Organization
Organization Name:SOUTH LOUISIANA ADDICTION TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAHOUSSAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-849-8965
Mailing Address - Street 1:2013 REES ST
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-4213
Mailing Address - Country:US
Mailing Address - Phone:337-332-4878
Mailing Address - Fax:
Practice Address - Street 1:2013 REES ST
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-4213
Practice Address - Country:US
Practice Address - Phone:337-332-4878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty