Organization
ELEVENTH ROUND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE PITTMAN CROWLEY LMSW (MANAGER)
(504) 237-5769
Entity
Organization
Contact information
Practice address
1418 WOODMERE DR, MANDEVILLE, LA 70471-7458
(504) 237-5769
Mailing address
1418 WOODMERE DR, MANDEVILLE, LA 70471-7458
(504) 237-5769
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3577
LA
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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