Organization
EXXODUS FOUNDATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEA ANNE ROBERTSON BS.,MS.,ESQ., (CEO., PRES., EXECUTIVE DIR., TRUST.)
(504) 392-0272
Entity
Organization
Contact information
Practice address
21 ENGLISH TURN DR, SUITE A, NEW ORLEANS, LA 70131-3308
(504) 392-0272
(504) 392-0274
Mailing address
21 ENGLISH TURN DR, SUITE A, NEW ORLEANS, LA 70131-3308
(504) 392-0272
(504) 392-0274
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
LA0974029834
LA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
LA9837472386
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LA12345678
—
LA
05
—
LA2019837465
—
LA
05
—
LA28176543
—
LA
05
—
LA9488487737
—
LA
Enumeration date
09/19/2007
Last updated
09/19/2007
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