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1295 Florida Ave Sw Denham Springs LA 70726-4635 | |
| (225) 243-5573 | |
| (225) 243-6029 |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1295 Florida Ave Sw, Denham Springs, Louisiana |
| Authorized Official Name and Position | David P Dickson (OWNER) |
| Authorized Official Contact | 2252435573 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1295 Florida Ave Sw Denham Springs LA 70726-4635 Ph: (225) 243-5573 | 1295 Florida Ave Sw Denham Springs LA 70726-4635 Ph: (225) 243-5573 |
| NPI Number | 1992042634 |
|---|---|
| Provider Enumeration Date | 01/15/2013 |
| Last Update Date | 01/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992042634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 576 (Louisiana) | Primary |
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