Healthcare Provider Details

I. General information

NPI: 1780838672
Provider Name (Legal Business Name): NON PROFIT CASE MANAGER SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7260 READ BLVD
NEW ORLEANS LA
70127-2226
US

IV. Provider business mailing address

PO BOX 671082
HOUSTON TX
77267-1082
US

V. Phone/Fax

Practice location:
  • Phone: 504-220-9131
  • Fax:
Mailing address:
  • Phone: 504-220-9131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number7710
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number7710
License Number StateLA

VIII. Authorized Official

Name: MS. LYNETTE H GILLARD
Title or Position: OWNER
Credential: BSW,RSW,MSW
Phone: 504-220-9131