VICTORY ADDICTION RECOVERY CENTER NPI 1497007694

NPI Information

VICTORY ADDICTION RECOVERY CENTER is a substance abuse rehabilitation facility in Lafayette, 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. VICTORY ADDICTION RECOVERY CENTER NPI is 1497007694. The provider is registered as an organization entity type.

The provider's business location address is:

111 LIBERTY AVE
LAFAYETTE, LA
ZIP 70508-821
Phone: (337) 456-9111
Fax: (337) 456-9131

The provider's authorized official is David A. Legendre .
The authorized official title is Ceo and has the following contact phone number (337) 456-9111.

The CLIA number assigned to this NPI record is 19D2047674 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2012 and was last updated on 4/29/2013.

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:

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