Healthcare Provider Details

I. General information

NPI: 1043546476
Provider Name (Legal Business Name): MRS. LUCINDA THERESA ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 10/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7041 READ LANE
NEW ORLEANS LA
70128-5204
US

IV. Provider business mailing address

10555 LAKE FOREST BLVD STE 9E
NEW ORLEANS LA
70127-5234
US

V. Phone/Fax

Practice location:
  • Phone: 504-220-1998
  • Fax: 504-241-7390
Mailing address:
  • Phone: 504-220-1998
  • Fax: 504-241-7390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number261QA0600X
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: