NPIMap

Organization Active NPI

Depart. Health and Hospitals

Doing business as Red River Medically Supported Detox

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Pineville, LA
National Provider Identifier
1326002155
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
License
162 Issued in LA
Legal business name
DEPART. HEALTH AND HOSPITALS
Doing business as
Red River Medically Supported Detox
Practice address
C/O Central State Hospital, Unit 6, Meadow Lane
Pineville, LA 71360
Phone
(318) 484-6400
Fax
(318) 487-5703
NPI assigned
Apr 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Mrs. Vicki G Cannella, LCSW-BACSNPI 1528171279
Title
Inpatient Facility Manager
Phone
(318) 484-6661

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X 162 LA Primary

Addresses

Primary practice location

C/O Central State Hospital, Unit 6, Meadow Lane
Pineville, LA 71360

Mailing address

PO Box 7118
Alexandria, LA 71306-0118
Phone (318) 484-6400

Other names 1

  • Red River Medically Supported Detox Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mansfield Behavioral Health31 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 1

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.

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": "1326002155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7118",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713060118",
            "telephone_number": "318-484-6400",
            "fax_number": "318-487-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C/O CENTRAL STATE HOSPITAL, UNIT 6, MEADOW LANE",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "71360",
            "telephone_number": "318-484-6400",
            "fax_number": "318-487-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPART. HEALTH AND HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CANNELLA",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "INPATIENT FACILITY MANAGER",
        "authorized_official_telephone_number": "318-484-6661",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-BACS"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "LA",
            "license": "162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red River Medically Supported Detox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pineville, 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.