| Organization Name: | DEPARTMENT OF HEALTH AND HOSPITALS |
| NPI Number: | 1023066230 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUDITH MICKENHEIM (CLINICAL COORDINATOR) |
| Mailing Address: | Washington Parish Adac 2106 Avenue F Bogalusa |
| State: | LA US |
| Postal Code: | 704275027 |
| Phone Number: | 9857326655 |
| Fax Number: | 9857326678 |
| NPI Enumeration Date: | 05/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 3514 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |