Gulf Coast Social Services, Inc. | |
2400 Edenborn Ave Metairie LA 70001-1817 | |
(504) 831-6561 | |
(504) 835-3156 |
Full Name | Gulf Coast Social Services, Inc. |
---|---|
Speciality | Community/behavioral Health |
Location | 2400 Edenborn Ave, Metairie, Louisiana |
Authorized Official Name and Position | Willie Green (CEO) |
Authorized Official Contact | 5048316561 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gulf Coast Social Services, Inc. 2400 Edenborn Ave Metairie LA 70001-1817 Ph: (504) 831-6561 | Gulf Coast Social Services, Inc. 2400 Edenborn Ave Metairie LA 70001-1817 Ph: (504) 831-6561 |
NPI Number | 1609904895 |
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Provider Enumeration Date | 03/01/2007 |
Last Update Date | 09/29/2022 |
Certification Date | 09/29/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609904895 | NPI | - | NPPES |
1910708 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 6904 (Louisiana) | Primary |
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