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Organization

PLTC-LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TERRY MARGARET MOGILLES RN (PROGRAM DIRECTOR)
(504) 827-2701
Entity
Organization

Contact information

Practice address
3330 CANAL ST, NEW ORLEANS, LA 70119-6206
(504) 827-2701
(504) 827-2715
Mailing address
3330 CANAL ST, NEW ORLEANS, LA 70119-6206
(504) 827-2701
(504) 827-2715

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2136593
LA
Enumeration date
08/16/2018
Last updated
08/16/2018
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