Organization
CENTER FOR LONGEVITY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TIFFANY ROBERTS SCHACHERL (BUSINESS MANAGER)
(504) 885-7360
Entity
Organization
Contact information
Practice address
3601 HOUMA BLVD, SUITE 300, METAIRIE, LA 70006-4326
(504) 885-7360
(504) 885-1360
Mailing address
3601 HOUMA BLVD, SUITE 300, METAIRIE, LA 70006-4326
(504) 885-7360
(504) 885-1360
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
012129
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5CF03
MEDICARE
—
Enumeration date
01/16/2008
Last updated
04/17/2008
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