Individual
MR. BRADLEY WAYNE ADAMS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23515 HIGHWAY 190, MANDEVILLE, LA 70448-7334
(985) 624-4100
Mailing address
23515 HIGHWAY 190, MANDEVILLE, LA 70448-7334
(985) 624-4100
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
083102
LA
Other
Enumeration date
07/02/2015
Last updated
07/02/2015
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