MEDICARE: NEW ORLEANS COLLEGE PREPATORY ACADEMICS

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	261QH0100X	Health Service Clinic/Center		LA

General Provider Information

NPI Number	:	1285916817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW ORLEANS COLLEGE PREPATORY ACADEMICS

Provider Business Mailing Address
First Line	:	3127 MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125-3328
Country	:	US
Telephone Number	:	504-388-2422
Fax Number	:	504-910-1045

Provider Business Practice Location Address
First Line	:	3127 MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125-3328
Country	:	US
Telephone Number	:	504-388-2422
Fax Number	:	504-910-1045

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. KRISTEN LOZADA
Credential	:
Telephone Number	:	504-388-2422

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	09/09/2011

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