Healthcare Provider Details

I. General information

NPI: 1073431581
Provider Name (Legal Business Name): PELICAN AUTISM CENTER OF EXCELLENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OAKLAND RD
KENNER LA
70065-6615
US

IV. Provider business mailing address

4232 WILLIAMS BLVD STE 106-112
KENNER LA
70065-2271
US

V. Phone/Fax

Practice location:
  • Phone: 504-319-1323
  • Fax:
Mailing address:
  • Phone: 504-319-1323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMAD CHEEMA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 504-319-1323