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NPI Code Detail

MEDICARE: NEW HOPE INTENSIVE OUTPATIENT SUBSTANCE ABUSE CLINIC

MEDICARE: NEW HOPE INTENSIVE OUTPATIENT SUBSTANCE ABUSE CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management AgencyMASTERS DEGREELA

General Provider Information

NPI Number : 1164895215
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW HOPE INTENSIVE OUTPATIENT SUBSTANCE ABUSE CLINIC
Provider Business Mailing Address
First Line : 5925 GREENWELL SPRINGS RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-1620
Country : US
Telephone Number : 225-926-7911
Fax Number :
Provider Business Practice Location Address
First Line : 5925 GREENWELL SPRINGS RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-1620
Country : US
Telephone Number : 225-926-7911
Fax Number :
Authorized Official
Title or Position : MENTAL HEALTH SPECIALIST
Name : MRS. MARCIA D RICHARDSON
Credential :
Telephone Number : 225-301-4762
Provider Enumeration Date : 11/10/2015
Last Update Date : 11/10/2015

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Directions to “NEW HOPE INTENSIVE OUTPATIENT SUBSTANCE ABUSE CLINIC ” Practice Location

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