Healthcare Provider Details

I. General information

NPI: 1285154690
Provider Name (Legal Business Name): VOLUNTEERS OF AMERICA SOUTHEAST LOUISIANA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 CARROLL ST STE B
MANDEVILLE LA
70448-5126
US

IV. Provider business mailing address

823 CARROLL ST STE B
MANDEVILLE LA
70448-5126
US

V. Phone/Fax

Practice location:
  • Phone: 985-674-0488
  • Fax:
Mailing address:
  • Phone: 985-674-0488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JASON BURT
Title or Position: EVP OF ENTERPRISE & ADMINISTRATIO
Credential:
Phone: 504-486-8674