NPIMap

Organization Active NPI

Florida Parishes Human Services Authority / Fontainebleau TX Center

  • Substance Abuse Rehabilitation Facility
  • Mandeville, LA
National Provider Identifier
1306800271
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
240 Issued in LA
Legal business name
FLORIDA PARISHES HUMAN SERVICES AUTHORITY / FONTAINEBLEAU TX CENTER
Practice address
23861 Robin Road & Hwy 190
Mandeville, LA 70447-0000
Phone
(985) 624-4100
Fax
(985) 624-4123
NPI assigned
Apr 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mohammad Ali Khan, M.D.
Title
Physician
Phone
(985) 624-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 240 LA Primary

Addresses

Primary practice location

23861 Robin Road & Hwy 190
Mandeville, LA 70447-0000

Mailing address

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

Other names 1

  • FONTAINEBLEAU TREATMENT CENTER Other name

National Provider Directory

National Provider Directory
Tax ID family
Child Adolescent Mental31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306800271",
    "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": "23861 ROBIN ROAD & HWY 190",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704470000",
            "telephone_number": "985-624-4100",
            "fax_number": "985-624-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PARISHES HUMAN SERVICES AUTHORITY / FONTAINEBLEAU TX CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "985-624-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "LA",
            "license": "240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FONTAINEBLEAU TREATMENT CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 22, 2020; 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.