Organization
HEALTHY AVENUES MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE GAUDIN LPN (OWNER)
(504) 883-7199
Entity
Organization
Contact information
Practice address
3303 TULANE AVE BLDG 1, NEW ORLEANS, LA 70119-7186
(504) 377-6628
(833) 907-2256
Mailing address
3303 TULANE AVE BLDG 1, NEW ORLEANS, LA 70119-7186
(504) 377-6628
(833) 907-2256
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20130196
LOUISIANA NURSING LICENSE
LA
Enumeration date
09/14/2022
Last updated
07/12/2023
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