Healthcare Provider Details

I. General information

NPI: 1427322072
Provider Name (Legal Business Name): POSITIVE DIRECTION SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 GENTILLY BLVD STE C400
NEW ORLEANS LA
70119-1700
US

IV. Provider business mailing address

1995 GENTILLY BLVD STE C400
NEW ORLEANS LA
70119-1700
US

V. Phone/Fax

Practice location:
  • Phone: 504-944-0453
  • Fax: 504-944-0095
Mailing address:
  • Phone: 504-944-0453
  • Fax: 504-944-0095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6470
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DETRA BLACKWELL
Title or Position: BUSINESS MANAGER
Credential:
Phone: 504-944-0453