# DEPARTMENT OF HEALTH AND HOSPITALS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** OBH-Bastrop Addictive Disorders Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174589022
- **Authorized official:** MR. PHYLLIS JERRI PARKS MSW (OAD/REGIONAL ADMINISTRATOR)
- **Authorized official phone:** (318) 362-3270

## Contact information

- **Practice address:** 320 S FRANKLIN ST, BASTROP, LA 71220-4539
- **Practice address phone:** (318) 283-0868
- **Practice address fax:** (318) 283-0875
- **Mailing address:** 320 S FRANKLIN ST, BASTROP, LA 71220-4539
- **Mailing address phone:** (318) 283-0868
- **Mailing address fax:** (318) 283-0875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LAC1076 | LA | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | RAC1081 | LA | — |
| 261QM1300X | Multi-Specialty Clinic/Center | MD014425 | LA | — |

## Other

- **Enumeration date:** 04/20/2006
- **Last updated:** 08/25/2010