Organization
MQVN COMMUNITY DEVELOPMENT CORPORATION
Active
Other names
NOELA Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACE CACIOPPO (COMPLIANCE AND CREDENTIALING OFFICE)
(504) 249-5834
Entity
Organization
Contact information
Practice address
13085 CHEF MENTEUR HWY, NEW ORLEANS, LA 70129-1804
(504) 255-8665
(504) 255-8665
Mailing address
4626 ALCEE FORTIER BLVD, NEW ORLEANS, LA 70129-2130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193200000X
MULTISPECIALITY GROUP PRACTICE
—
Enumeration date
09/14/2009
Last updated
05/08/2025
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