Provider Demographics
NPI:1548538804
Name:CENLA CHEMICAL DEPENDENCY COUNCIL, INC
Entity type:Organization
Organization Name:CENLA CHEMICAL DEPENDENCY COUNCIL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PFLIPSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-484-6778
Mailing Address - Street 1:PO BOX 4582
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71361-4582
Mailing Address - Country:US
Mailing Address - Phone:318-484-6778
Mailing Address - Fax:318-484-6502
Practice Address - Street 1:LINCOLN STREET UNIT 24
Practice Address - Street 2:CLSH
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-0000
Practice Address - Country:US
Practice Address - Phone:318-484-6778
Practice Address - Fax:318-484-6502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA214324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility