MEDICARE: CBI INSURANCE & CARE MANAGEMENT

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	251C00000X	Developmentally Disabled Services Day Training Agency	15459	LA
2	253Z00000X	In Home Supportive Care Agency	15459	LA
3	252Y00000X	Early Intervention Provider Agency	15459	LA

General Provider Information

NPI Number	:	1285931287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CBI INSURANCE & CARE MANAGEMENT

Provider Business Mailing Address
First Line	:	PO BOX 870095
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70187-0095
Country	:	US
Telephone Number	:	504-242-1545
Fax Number	:	504-248-1989

Provider Business Practice Location Address
First Line	:	10555 LAKE FOREST BLVD
Second Line	:	SUITE 7-N
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-5206
Country	:	US
Telephone Number	:	504-242-1545
Fax Number	:	504-248-1989

Authorized Official
Title or Position	:	PRESIDENT/PROGRAM MANAGER
Name	:	MS. MICHELE THORNTON-BROWN
Credential	:
Telephone Number	:	504-242-1545

Provider Enumeration Date	:	02/28/2011
Last Update Date	:	02/28/2011

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