PECAN HAVEN ADDICTION RECOVERY CENTER, LLC


Address: 2321 Hwy 80 East, Monroe, LA 71203
Phone: 3186003333

PECAN HAVEN ADDICTION RECOVERY CENTER, LLC (NPI# 1366820706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366820706
Entity Type Organization
Organization Name PECAN HAVEN ADDICTION RECOVERY CENTER, LLC
Other Organization Name PECAN HAVEN ADOLESCENT ADDICTION CENTER
Practice Address 2321 Hwy 80 East
Monroe
LA 71203
Practice Telephone 3186003333
Practice Fax Number 3186003334
Mailing Telephone 3186003333
Mailing Fax Number 3186003334
Enumeration Date 2015-05-18
Last Update Date 2016-09-14
Authorized Official Name AMANDA PEELER FONTENOT (BUSINESS MANAGER)
Authorized Official Telephone 3186003333
Authorized Official Credential CPPM
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 324500000X Substance Abuse Rehabilitation Facility 220382709 LA Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Pecan Haven Adolescent Addiction Center Former Legal Business Name - Organization

Office Location

Street Address 2321 HWY 80 EAST
City MONROE
State LA
Zip Code 71203

Providers in the same zip code

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1801408083 Bwilling Counseling, LLC Counselor 1500 North 19th Street, Monroe, La 71201, LA 71203 2020-08-19
1427683234 Alexander Lee Forehan Specialist/Technologist 4099 Northeast Dr, Monroe, LA 71203 2020-03-12
1568923092 Northeast Louisiana Veteran's Home Department of Veterans Affairs (VA) Pharmacy 6700 Highway 165n, Monroe, LA 71203 2019-03-27
1144708520 Cassie Lord Pharmacist Brookshires, 7920 Desiard Street, Monroe, LA 71203 2018-07-30
1982196465 Emmanuel D Hardy Case Manager/Care Coordinator 645 Hwy 80 East, Monroe, LA 71203 2018-05-31
1831689652 Shereka Ruenet Devall Counselor 202 Lincoln Rd, Monroe, LA 71203 2018-05-17
1356830541 David Whitney Bass Counselor 622 Riverside Drive, Monroe, La. 71203, Monroe, LA 71203 2018-05-03
1851821912 Niatra S Bell Counselor 645 Highway 80 East, Monroe, LA 71203 2017-06-12
1528597523 Amazing Transport, LLC Non-emergency Medical Transport (VAN) 6300 Mosswood Dr., Monroe, LA 71203 2017-06-05
1326581737 Charla Gix Case Manager/Care Coordinator 645 Us-80, Monroe, LA 71203 2016-12-02
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Taxonomy Information

Taxonomy Code 324500000X
Grouping Residential Treatment Facilities
Classification Substance Abuse Rehabilitation Facility

Taxonomy Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Notes: [7/1/2003: modified title, modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881233419 Addiction Solutions LLC Substance Abuse Rehabilitation Facility 216 Ouachita Ave Ste B, Monroe, LA 71201-8513 2019-12-30
1740654920 Summit Bhc Monroe, LLC Substance Abuse Rehabilitation Facility 398 Highway 11 Sw, Monroe, GA 30655-6071 2015-11-25
1598037079 Rays of Sonshine Substance Abuse Rehabilitation Facility 200 Breard St, Monroe, LA 71201-6704 2012-01-31
1558902916 Serenity Sober Livving, LLC Substance Abuse Rehabilitation Facility 4600 Reddix Ln, Monroe, LA 71202-5949 2019-10-07
1760044754 Milestone Recovery Substance Abuse Rehabilitation Facility 1805 Martin Luther King Jr Dr, Monroe, LA 71202-4517 2019-07-01
1801326723 Applegate Health Services, Inc Substance Abuse Rehabilitation Facility 3001 Armand St Ste A, Monroe, LA 71201-3761 2017-06-13
1548706765 Christ Association Substance Abuse Rehabilitation Facility 700 S 6th St, Monroe, LA 71202-2226 2017-01-11
1942754049 Kathy Wright Substance Abuse Rehabilitation Facility 1408 E Franklin St, Monroe, NC 28112-5160 2016-08-08
1225410632 Women Empowering Women, Inc. Substance Abuse Rehabilitation Facility 3580 S Custer Rd, Monroe, MI 48161-9774 2015-06-22
1861747578 Salvation Army Harbor Light Substance Abuse Rehabilitation Facility 3250 N Monroe St, Monroe, MI 48162-9297 2012-07-18
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Competitor

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City MONROE
Zip Code 71203

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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