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Organization

DESTINED FOR A CHANGE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NEDDESHA STALKS (EXECUTIVE DIRECTOR)
(504) 766-7098
Entity
Organization

Contact information

Practice address
2968 GENERAL COLLINS AVE, NEW ORLEANS, LA 70114
(504) 394-5937
(504) 394-8197
Mailing address
2968 GENERAL COLLINS AVE, NEW ORLEANS, LA 70114-6859
(504) 394-5937
(504) 394-8197

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2153374
LA
01
2203783927
BHSP
LA
Enumeration date
11/07/2010
Last updated
04/11/2026
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