Organization
DEPENDENCY RELIEF CENTERS OF AMERICA LLC
Active
Other names
Dependency Pain Treatment Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN FORMAN (PRESIDENT/CEO)
(504) 535-7212
Entity
Organization
Contact information
Practice address
3439 PRYTANIA ST, STE 501, NEW ORLEANS, LA 70115-7905
(504) 535-7212
(504) 814-1011
Mailing address
1441 CANAL ST, STE 324, NEW ORLEANS, LA 70112-2714
(504) 535-7212
(504) 814-1011
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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