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PECAN HAVEN ADDICTION RECOVERY CENTER LLC NPI 1366820706


NPI Information

NPI: 1366820706
Provider Name: PECAN HAVEN ADDICTION RECOVERY CENTER, LLC

Former Legal Business Name: PECAN HAVEN ADOLESCENT ADDICTION CENTER

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 19D2101759

Address:
2321 HWY 80 EAST
MONROE, LA
ZIP 71203
Phone: (318) 600-3333
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PECAN HAVEN ADDICTION RECOVERY CENTER, LLC is a substance abuse rehabilitation facility in Monroe, LA. The provider is 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. PECAN HAVEN ADDICTION RECOVERY CENTER, LLC NPI is 1366820706. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Pecan Haven Adolescent Addiction Center.

The provider's business location address is:

2321 HWY 80 EAST
MONROE, LA
ZIP 71203
Phone: (318) 600-3333
Fax: (318) 600-3334

The provider's authorized official is Amanda Peeler Fontenot .
The authorized official title is Business Manager and has the following contact phone number (318) 600-3333.

The CLIA number assigned to this NPI record is 19D2101759 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/18/2015 and was last updated on 9/14/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation Facility220382709LOUISIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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