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Organization
LAKELAND HEALTHCARE HOME & COMMUNITY BASED WAVER
Active
Organization
LAKELAND HEALTHCARE HOME & COMMUNITY BASED WAVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALLEN MORAD (CEO)
(504) 891-8100
Entity
Organization
Contact information
Practice address
105 MEDICAL CENTER DR STE 206, SLIDELL, LA 70461-5538
(985) 781-7117
(504) 891-8156
Mailing address
3525 PRYTANIA ST STE 609, NEW ORLEANS, LA 70115-3545
(504) 891-8100
(504) 891-8156
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PCA 7025
LA
Other
Enumeration date
03/01/2007
Last updated
08/22/2020
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