Nola Detox, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

NOLA DETOX, LLC

Doing business as

Nola Detox

Practice address

4201 Woodland Dr FL 3
New Orleans, LA 70131-7339

Phone

(504) 975-5552

NPI assigned

May 13, 2021

Last updated

Jan 28, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel Forman

Title

Administrator

Phone

(504) 975-5552

Specialties & licenses 1

Addresses

Other names 1

• Nola Detox Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1649844838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 BEHRMAN PL STE 202A",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701148270",
            "telephone_number": "504-975-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 WOODLAND DR FL 3",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701317339",
            "telephone_number": "504-975-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOLA DETOX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-13",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "FORMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "504-975-5552"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dan@noladetox.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "dan@noladetox.com",
            "address_1": "4201 Woodland Dr Fl 3",
            "city": "New Orleans",
            "state": "LA",
            "country_code": "US",
            "postal_code": "701317339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Nola Detox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Substance Abuse Rehabilitation Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.