Organization
ACADIANA ADDICTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ALEXANDER DECLOUET PMHNP (NURSE PRACTITIONER)
(337) 484-1415
Entity
Organization
Contact information
Practice address
218 RUE BEAUREGARD STE C, LAFAYETTE, LA 70508-3284
(337) 484-1415
(337) 484-1419
Mailing address
218 RUE BEAUREGARD STE C, LAFAYETTE, LA 70508-3284
(337) 484-1415
(337) 484-1419
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1518342310
LA
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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