Organization
OH PROJECT- NORTHSHORE
Active
Parent organization
OHANA HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
OHANA HEALTHCARE
Authorized official
TYRONE LUSTER (OWNER)
(901) 626-2129
Entity
Organization
Contact information
Practice address
190 GREENBRIER BLVD STE 105, COVINGTON, LA 70433-7237
(985) 276-3040
Mailing address
PO BOX 957, MADISONVILLE, LA 70447-0957
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/09/2018
Last updated
11/09/2018
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