MEDICARE: RAINTREE CHILDREN AND FAMILY SERVICES

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
1	251B00000X	Case Management Agency	CM2128	LA

General Provider Information

NPI Number	:	1275665077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAINTREE CHILDREN AND FAMILY SERVICES

Provider Business Mailing Address
First Line	:	1233 8TH ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-3332
Country	:	US
Telephone Number	:	504-899-9045
Fax Number	:	504-895-0204

Provider Business Practice Location Address
First Line	:	1233 8TH ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-3332
Country	:	US
Telephone Number	:	504-899-9045
Fax Number	:	504-895-0204

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. LAURA JENSEN
Credential	:
Telephone Number	:	504-899-9045

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	08/22/2020

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