MEDICARE: PYRAMID RESOURCES WELLNESS INSTITUTE

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1518308634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PYRAMID RESOURCES WELLNESS INSTITUTE

Provider Business Mailing Address
First Line	:	3330 CANAL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-6206
Country	:	US
Telephone Number	:	504-827-2708
Fax Number	:	504-827-2715

Provider Business Practice Location Address
First Line	:	3330 CANAL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-6206
Country	:	US
Telephone Number	:	504-827-2708
Fax Number	:	504-827-2715

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. TERRY MOGILLES
Credential	:	RN
Telephone Number	:	504-827-2708

Provider Enumeration Date	:	07/17/2013
Last Update Date	:	07/17/2013

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