Organization
DEPT. OF HEALTH & HOSPITALS
Active
Other names
Red River Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI CANNELLA LCSW, BACS (INPATIENT FACILITY MANAGER)
(318) 484-6661
Entity
Organization
Contact information
Practice address
MEADOW LANE, C/O CENTRAL STATE HOSPITAL, UNIT 6,, PINEVILLE, LA 71360
(318) 484-6400
(318) 487-5703
Mailing address
PO BOX 7118, ALEXANDRIA, LA 71306-0118
(318) 484-6400
(318) 487-5703
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
162
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0545
BLUE CROSS BLUE SHIELD
LA
Enumeration date
04/17/2006
Last updated
08/22/2020
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