NPIMap

Organization Active NPI

Jeff Davis Addictive Disorders Clinic

  • Community/Behavioral Health Agency
  • Jennings, LA
National Provider Identifier
1346589843
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
SA0003505 Issued in LA
Legal business name
JEFF DAVIS ADDICTIVE DISORDERS CLINIC
Practice address
221 E Academy Ave Ste a
Jennings, LA 70546-5331
Phone
(337) 824-4705
Fax
(337) 824-4827
NPI assigned
Feb 5, 2013
Last updated
Feb 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Authorized official

Name
Mr. Wendell Miller
Title
Board President
Phone
(337) 824-8885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X SA0003505 LA Primary

Addresses

Primary practice location

221 E Academy Ave Ste a
Jennings, LA 70546-5331

Mailing address

221 E Academy Ave Ste a
Jennings, LA 70546-5331
Phone (337) 824-4705

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1346589843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E ACADEMY AVE STE A",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705465331",
            "telephone_number": "337-824-4705",
            "fax_number": "337-824-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E ACADEMY AVE STE A",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705465331",
            "telephone_number": "337-824-4705",
            "fax_number": "337-824-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF DAVIS ADDICTIVE DISORDERS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-05",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "337-824-8885",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "SA0003505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.