| Creed Group Of Louisiana Llc | |
|
2235 Poydras St Ste A New Orleans LA 70119-7561 | |
| (504) 814-8001 | |
| (504) 814-8002 |
| Full Name | Creed Group Of Louisiana Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2235 Poydras St Ste A, New Orleans, Louisiana |
| Authorized Official Name and Position | Corey Scott (CEO) |
| Authorized Official Contact | 5048148001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creed Group Of Louisiana Llc 2235 Poydras St Ste A New Orleans LA 70119-7561 Ph: (504) 814-8001 | Creed Group Of Louisiana Llc 2235 Poydras St Ste A New Orleans LA 70119-7561 Ph: (504) 814-8001 |
| NPI Number | 1922512326 |
|---|---|
| Provider Enumeration Date | 11/21/2017 |
| Last Update Date | 01/25/2021 |
| Certification Date | 10/26/2020 |
| Medicare PECOS PAC ID | 5698016632 |
|---|---|
| Medicare Enrollment ID | O20190401001655 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922512326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Alphonse K Roy |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1730186750 PECOS PAC ID: 1153510698 Enrollment ID: I20110601000692 |
| Provider Name | Paula S Bland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134414535 PECOS PAC ID: 6608045158 Enrollment ID: I20110818000035 |
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