Healthcare Provider Details

I. General information

NPI: 1942576814
Provider Name (Legal Business Name): DHH/OBH/MHSD/OPJC PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 CANAL ST SUITE 303
NEW ORLEANS LA
70119-6082
US

IV. Provider business mailing address

3801 CANAL ST SUITE 303
NEW ORLEANS LA
70119-6082
US

V. Phone/Fax

Practice location:
  • Phone: 504-483-7240
  • Fax: 504-483-7248
Mailing address:
  • Phone: 504-483-7240
  • Fax: 504-483-7248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateLA

VIII. Authorized Official

Name: MRS. GILDA ARMSTRONG BUTLER
Title or Position: DIRECTOR
Credential: LCSW
Phone: 225-342-3592