Healthcare Provider Details

I. General information

NPI: 1316543887
Provider Name (Legal Business Name): OBYKE HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3028 GENTILLY BLVD
NEW ORLEANS LA
70122-3808
US

IV. Provider business mailing address

5817 HICKORY CREEK RD APT 249
RIVER RIDGE LA
70123-6063
US

V. Phone/Fax

Practice location:
  • Phone: 504-948-6089
  • Fax:
Mailing address:
  • Phone: 504-669-9530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: URSULA NEWELL DAVIS
Title or Position: SOCIAL WORKER
Credential:
Phone: 504-400-3448