Organization
EKHAYA YOUTH PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BANTU D. GROSS PH.D. (MENTAL HEALTH PROFESSIONAL)
(504) 940-8249
Entity
Organization
Contact information
Practice address
1112 5TH ST, GRETNA, LA 70053-6008
(504) 373-6026
Mailing address
2209 S GAYOSO ST, NEW ORLEANS, LA 70125-4425
(504) 940-8249
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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