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Organization

VICTORY ADDICTION RECOVERY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID A. LEGENDRE PHD (CEO)
(337) 456-9111
Entity
Organization

Contact information

Practice address
111 LIBERTY AVE, LAFAYETTE, LA 70508-6821
(337) 456-9111
(337) 456-9131
Mailing address
111 LIBERTY AVE, LAFAYETTE, LA 70508-6821
(337) 456-9111
(337) 456-9131

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
2203781178
LA
324500000X
Substance Abuse Rehabilitation Facility
LA

Other

Enumeration date
10/11/2012
Last updated
04/29/2013
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