Healthcare Provider Details

I. General information

NPI: 1154478345
Provider Name (Legal Business Name): NEW FREEDOM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 VETERANS MEMORIAL BLVD SUITE 202A
METAIRIE LA
70005-3027
US

IV. Provider business mailing address

110 VETERANS MEMORIAL BLVD SUITE 202A
METAIRIE LA
70005-3027
US

V. Phone/Fax

Practice location:
  • Phone: 504-888-8600
  • Fax: 504-832-7947
Mailing address:
  • Phone: 504-888-8600
  • Fax: 504-832-7947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number218
License Number StateLA

VIII. Authorized Official

Name: SUSAN GEMAR ANDERSON
Title or Position: CAO
Credential:
Phone: 504-888-8600