MEDICARE: KENNISE REED

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	311ZA0620X	Adult Care Home Facility	SIL 12253	LA

General Provider Information

NPI Number	:	1609032572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNISE REED

Provider Business Mailing Address
First Line	:	4480 GENERAL DEGAULLE DR
Second Line	:	SUITE 114
City	:	NEW ORLEANS
State	:	LA
Zip	:	70131-6941
Country	:	US
Telephone Number	:	504-394-7700
Fax Number	:	504-394-7058

Provider Business Practice Location Address
First Line	:	4480 GENERAL DEGAULLE DR
Second Line	:	SUITE 114
City	:	NEW ORLEANS
State	:	LA
Zip	:	70131-6941
Country	:	US
Telephone Number	:	504-394-7700
Fax Number	:	504-394-7058

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KENNISE REED
Credential	:
Telephone Number	:	504-394-7700

Provider Enumeration Date	:	07/31/2008
Last Update Date	:	07/31/2008

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Directions to “KENNISE REED ” Practice Location

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