Organization · Type 2 NPI

Penn 123 LLC

Substance Use Disorder Rehabilitation Clinic/Center · Metairie, LA

NPI number 1144915786 Active

Practice location

4933 Wabash St
Metairie, LA 70001-1031

Mailing address

211 Boulevard Of The Americas, Suite 503
Lakewood, NJ 08701

Specialties and licenses

TaxonomyCodeLicense
Community/Behavioral Health Agency 251S00000XNone listed
Substance Use Disorder Rehabilitation Clinic/Center Primary 261QR0405XNone listed
Substance Abuse Rehabilitation Facility 324500000XNone listed

Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...

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About NPI 1144915786

Penn 123 LLC's National Provider Identifier is 1144915786, issued on Apr 10, 2023. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Metairie, LA. The record was last updated on Apr 10, 2023.