Organization
SIRI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TOBY CHALONE BRANDEN (BOARD SECRETARY)
(504) 520-0125
Entity
Organization
Contact information
Practice address
1721 SAINT PHILIP ST, NEW ORLEANS, LA 70116-2116
(504) 220-8786
(713) 490-2683
Mailing address
1722 SAINT PHILIP ST, NEW ORLEANS, LA 70116-2117
(504) 220-8786
(713) 490-2683
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/28/2006
Last updated
08/15/2008
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