# LACED BOUTIQUE AND SALON LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elite Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669256384
- **Authorized official:** SHAWNDRICK R. REDDING (OWNER AUTHORIZED)
- **Authorized official phone:** (225) 449-0102

## Contact information

- **Practice address:** 4701 S CARROLLTON AVE, NEW ORLEANS, LA 70119-6026
- **Practice address phone:** (504) 494-3895
- **Mailing address:** 4701 S CARROLLTON AVE, NEW ORLEANS, LA 70119-6026
- **Mailing address phone:** (504) 494-3895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2023
- **Last updated:** 09/02/2025