Healthcare Provider Details

I. General information

NPI: 1043531312
Provider Name (Legal Business Name): GULF COAST TEACHING FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 POINT ST
HOUMA LA
70360-4744
US

IV. Provider business mailing address

2400 EDENBORN AVE
METAIRIE LA
70001-1817
US

V. Phone/Fax

Practice location:
  • Phone: 985-851-4488
  • Fax: 985-872-0985
Mailing address:
  • Phone: 504-831-6561
  • Fax: 504-835-3156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIE GREEN
Title or Position: CEO
Credential: MPA
Phone: 504-831-6561