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725 Vallette St New Orleans LA 70114-4347 | |
(504) 903-2373 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Community Health |
Location | 725 Vallette St, New Orleans, Louisiana |
Authorized Official Name and Position | Roxane A. Townsend (INTERIM CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5049034907 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2021 Perdido St New Orleans LA 70112-1352 Ph: (504) 903-5153 | 725 Vallette St New Orleans LA 70114-4347 Ph: (504) 903-2373 |
NPI Number | 1154624468 |
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Provider Enumeration Date | 12/08/2010 |
Last Update Date | 12/08/2010 |
Identifier | Type | State | Issuer |
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1154624468 | NPI | - | NPPES |
1765651 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | 191-J (Louisiana) | Primary |
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