Organization
GRACE OUTREACH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY NOAH (PASTOR/DIRECTOR)
(504) 913-5452
Entity
Organization
Contact information
Practice address
2533 LASALLE ST, NEW ORLEANS, LA 70113-2531
(504) 913-5452
(504) 367-6601
Mailing address
2533 LASALLE ST, NEW ORLEANS, LA 70113-2531
(504) 913-5452
(504) 367-6601
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
453
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000
—
LA
Enumeration date
08/17/2010
Last updated
08/17/2010
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