# MAGNOLIA ADDICTION TREATMENT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750513818
- **Authorized official:** DR. CHAD W TROSCLAIR MD (CLINICAL MANAGER)
- **Authorized official phone:** (504) 905-2965

## Contact information

- **Practice address:** 500 E WOODROW WILSON AVE STE D, JACKSON, MS 39216-4538
- **Practice address phone:** (601) 896-0349
- **Mailing address:** 500 E WOODROW WILSON AVE STE D, JACKSON, MS 39216-4538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/21/2009
- **Last updated:** 08/21/2009