Organization · Type 2 NPI

Fphsa

Substance Abuse Rehabilitation Facility · Mandeville, LA

NPI number 1104376342 Active

Practice location

23515 Highway 190
Mandeville, LA 70448-7334

Fax (985) 624-4123

Mailing address

PO Box 37
Mandeville, LA 70470-0037

Specialties and licenses

TaxonomyCodeLicense
Substance Abuse Rehabilitation Facility Primary 324500000X960733 (LA)

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

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About NPI 1104376342

Fphsa's National Provider Identifier is 1104376342, issued on Oct 12, 2016. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Mandeville, LA. The record was last updated on Oct 12, 2016.