Organization
HOUSE OF JACOB HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESTHER CLARISSE WANDA PHARM.D. (PRESIDENT)
(504) 251-8477
Entity
Organization
Contact information
Practice address
316 FILMORE ST, KENNER, LA 70062-7810
(504) 305-0035
(504) 305-0004
Mailing address
316 FILMORE ST, KENNER, LA 70062-7810
(504) 305-0035
(504) 305-0004
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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