Sanctuary Louisiana LLC
Clinic/Center, Rehabilitation, Substance Use Disorder in Lacassine, LA. Organization (NPI-2).
NPI number1982215851
StatusActive
Last updated in NPPESAug 29, 2023
Details
- NPI
- 1982215851
- Entity type
- Organization (NPI-2)
- Legal business name
- Sanctuary Louisiana LLC
- Organization subpart
- Yes
- Enumeration date
- Aug 13, 2020
- Certification date
- Aug 29, 2023
- Last updated
- Aug 29, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 101YP2500X | Counselor, Professional | – | – | |
| 207RA0401X | Internal Medicine, Addiction Medicine | – | – | |
| 207RR0500X | Internal Medicine, Rheumatology | – | – | |
| 208D00000X | General Practice | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Other names
- Sanctuary Of Louisiana Clinic (Doing Business As)
Practice location
21089 South Frontage RoadLacassine, LA 70650-9998
Phone 337-936-9197 · Fax 337-588-4179
Mailing address
Po Box 1967Iowa, LA 70647-1967
Phone 337-936-9197
Authorized official
Kelvin Smith
Administrator
3379369197
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.