Healthcare Provider Details

I. General information

NPI: 1841522711
Provider Name (Legal Business Name): PRIORITY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 09/02/2025
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 WESTBANK EXPY
GRETNA LA
70053-3647
US

IV. Provider business mailing address

4700 WICHERS DR STE 306
MARRERO LA
70072-3054
US

V. Phone/Fax

Practice location:
  • Phone: 504-509-4800
  • Fax: 504-509-4802
Mailing address:
  • Phone: 504-309-6057
  • Fax: 504-309-6084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateLA

VIII. Authorized Official

Name: MRS. TAMARA BOUTTE DIOUBATE
Title or Position: CEO
Credential: MSW, MSHCM
Phone: 504-309-6522