| Gulf Coast Social Services, Inc. | |
|
906 Cm Fegan Drive Ste 3b/4b Hammond LA 70403 | |
| (985) 542-1191 | |
| (985) 345-9910 |
| Full Name | Gulf Coast Social Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 906 Cm Fegan Drive, Hammond, 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. 906 Cm Fegan Drive Ste 3b/4b Hammond LA 70403 Ph: (985) 542-1191 |
| NPI Number | 1508992454 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 10/03/2022 |
| Certification Date | 09/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508992454 | NPI | - | NPPES |
| 1690091 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | RC6597 (Louisiana) | Primary |
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