Provider Demographics
NPI:1265198543
Name:ADDICTION SPECIALISTS
Entity type:Organization
Organization Name:ADDICTION SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-756-9242
Mailing Address - Street 1:4330 LOVELAND ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4176
Mailing Address - Country:US
Mailing Address - Phone:888-488-5253
Mailing Address - Fax:
Practice Address - Street 1:4330 LOVELAND ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4176
Practice Address - Country:US
Practice Address - Phone:888-488-5253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPENDINGMedicaid
LAPENDINGOtherPHYSICIAN GROUP SPECIALITY