NPIMap

Organization Active NPI

Fphsa

  • Substance Abuse Rehabilitation Facility
  • Mandeville, LA
National Provider Identifier
1104376342
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
960733 Issued in LA
Legal business name
FPHSA
Practice address
23515 Highway 190
Mandeville, LA 70448-7334
Phone
(985) 624-4100
Fax
(985) 624-4123
NPI assigned
Oct 12, 2016
Last updated
Oct 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Nadine Faciane
Title
Program Director
Phone
(985) 624-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 960733 LA Primary

Addresses

Primary practice location

23515 Highway 190
Mandeville, LA 70448-7334

Mailing address

PO Box 37
Mandeville, LA 70470-0037
Phone (985) 624-4100

National Provider Directory

National Provider Directory
Tax ID family
Fphsa Alcohol Drug Unit11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1104376342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704700037",
            "telephone_number": "985-624-4100",
            "fax_number": "985-624-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23515 HIGHWAY 190",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487334",
            "telephone_number": "985-624-4100",
            "fax_number": "985-624-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FPHSA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "FACIANE",
        "authorized_official_first_name": "NADINE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "985-624-4100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "LA",
            "license": "960733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.