Gulf South Addiction & Wellness

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

2203782288 Issued in LA

Legal business name

GULF SOUTH ADDICTION & WELLNESS

Practice address

1539 Jackson Ave
Suite 220
New Orleans, LA 70130-5858

Phone

(985) 781-0548

Fax

(985) 781-4319

NPI assigned

Mar 18, 2015

Organization subpart

No

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Harminder S Mallik, MD

  • Psychiatry Physician
  • New Orleans, LA
  • NPI 1336209238

  LA

  Medicare reassignment Authorized official

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

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

Authorized official

Name

Dr. Harminder S Mallik, MDNPI 1336209238

Title

Owner

Phone

(985) 781-0548

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1235523085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 JACKSON AVE",
            "address_2": "SUITE 220",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701305858",
            "telephone_number": "985-781-0548",
            "fax_number": "985-781-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 JACKSON AVE",
            "address_2": "SUITE 220",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701305858",
            "telephone_number": "985-781-0548",
            "fax_number": "985-781-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF SOUTH ADDICTION & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-18",
        "last_updated": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "MALLIK",
        "authorized_official_first_name": "HARMINDER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-781-0548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "LA",
            "license": "2203782288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2203782288",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maged Nabil Aziz Guirguis, M.D.
• Hannah Guise, PTA
• Kelli Guise, LPC, NCC
• Leslie G Guitart, CRNA
• Shivam Gulati
• Gulf South Therapy
• Gull Inpatient Services, LLC
• Troy James Gullage
• Paul M Gulotta, MD
• Tarini Natalya Elapata Gunaratne, MD

• All providers in New Orleans, LA
• Substance Use Disorder Rehabilitation Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.