Organization
JEFF DAVIS ADDICTIVE DISORDERS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WENDELL MILLER (BOARD PRESIDENT)
(337) 824-8885
Entity
Organization
Contact information
Practice address
221 E ACADEMY AVE STE A, JENNINGS, LA 70546-5331
(337) 824-4705
(337) 824-4827
Mailing address
221 E ACADEMY AVE STE A, JENNINGS, LA 70546-5331
(337) 824-4705
(337) 824-4827
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SA0003505
LA
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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