Organization
NESS HEALTHCARE NFP
Active
Other names
Northlake Behavioral Health System
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY SHIR (PRESIDENT)
(847) 452-4565
Entity
Organization
Contact information
Practice address
23515 HWY 190, MANDEVILLE, LA 70448
(847) 452-4585
(985) 626-6559
Mailing address
23515 HWY 190, MANDEVILLE, LA 70448
(847) 452-4585
(985) 626-6559
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
283Q00000X
Psychiatric Hospital
Primary
214
LA
323P00000X
Psychiatric Residential Treatment Facility
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710059
—
LA
05
—
2700111
—
LA
Enumeration date
05/20/2006
Last updated
04/06/2022
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