Healthcare Provider Details

I. General information

NPI: 1720253131
Provider Name (Legal Business Name): LSUHSC-NEW ORLEANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 BOLIVAR ST
NEW ORLEANS LA
70112-2256
US

IV. Provider business mailing address

5912 SAINT CHARLES AVE APT. J
NEW ORLEANS LA
70115-5064
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-7912
  • Fax:
Mailing address:
  • Phone: 504-568-7912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberGETP.LSU.P
License Number StateLA

VIII. Authorized Official

Name: DR. MARGARET BAIER
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 50456879123