Organization
GULF SOUTH ADDICTION & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARMINDER S MALLIK MD (OWNER)
(985) 781-0548
Entity
Organization
Contact information
Practice address
1539 JACKSON AVE, SUITE 220, NEW ORLEANS, LA 70130-5858
(985) 781-0548
(985) 781-4319
Mailing address
1539 JACKSON AVE, SUITE 220, NEW ORLEANS, LA 70130-5858
(985) 781-0548
(985) 781-4319
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
2203782288
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2203782288
STATE LICENSE
LA
Enumeration date
03/18/2015
Last updated
11/16/2023
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