Healthcare Provider Details

I. General information

NPI: 1982373288
Provider Name (Legal Business Name): CHITIN BUSINESS SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23515 HIGHWAY 190
MANDEVILLE LA
70448-7334
US

IV. Provider business mailing address

91 CARDINAL LN
MANDEVILLE LA
70471-6758
US

V. Phone/Fax

Practice location:
  • Phone: 985-626-6300
  • Fax: 985-781-4319
Mailing address:
  • Phone: 985-781-0548
  • Fax: 985-781-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HYON S KIM
Title or Position: OWNER
Credential: MD
Phone: 985-781-0548