# DEPARTMENT OF HEALTH & HOSPITALS

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

## Provider details

- **NPI number:** 1699726299
- **Authorized official:** WILLIE WALLACE MSW (CLINIC MANAGER)
- **Authorized official phone:** (985) 543-4071

## Contact information

- **Practice address:** 202 E ROBERT ST, HAMMOND, LA 70401-3350
- **Practice address phone:** (985) 543-4070
- **Practice address fax:** (985) 543-4073
- **Mailing address:** 202 E ROBERT ST, HAMMOND, LA 70401-3350
- **Mailing address phone:** (985) 543-4070
- **Mailing address fax:** (985) 543-4073

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 023 | LA | Yes |

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 02/19/2013