| NPI | 1265676860 |
|---|---|
| Doing Business As | FPHSA/HAMMOND A D C |
| Entity Type | Organization |
| Authorized Contact | WILLIE J. WALLACE Clinic Manager 985-543-4070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: LA 395A) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |