# DEPART. HEALTH AND HOSPITALS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Red River Medically Supported Detox
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326002155
- **Authorized official:** MRS. VICKI G CANNELLA LCSW-BACS (INPATIENT FACILITY MANAGER)
- **Authorized official phone:** (318) 484-6661

## Contact information

- **Practice address:** C/O CENTRAL STATE HOSPITAL, UNIT 6, MEADOW LANE, PINEVILLE, LA 71360
- **Practice address phone:** (318) 484-6400
- **Practice address fax:** (318) 487-5703
- **Mailing address:** PO BOX 7118, ALEXANDRIA, LA 71306-0118
- **Mailing address phone:** (318) 484-6400
- **Mailing address fax:** (318) 487-5703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 276400000X | Substance Use Disorder Rehabilitation Hospital Unit | 162 | LA | Yes |

## Other

- **Enumeration date:** 04/17/2006
- **Last updated:** 08/22/2020