Organization
DEPARTMENT OF HEALTH & HOSPITALS
Active
Other names
Hammond Addictive Disorders Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE WALLACE MSW (CLINIC MANAGER)
(985) 543-4071
Entity
Organization
Contact information
Practice address
202 E ROBERT ST, HAMMOND, LA 70401-3350
(985) 543-4070
(985) 543-4073
Mailing address
202 E ROBERT ST, HAMMOND, LA 70401-3350
(985) 543-4070
(985) 543-4073
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
023
LA
Other
Enumeration date
05/16/2006
Last updated
02/19/2013
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