Healthcare Provider Details

I. General information

NPI: 1275665077
Provider Name (Legal Business Name): RAINTREE CHILDREN AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 8TH ST
NEW ORLEANS LA
70115-3332
US

IV. Provider business mailing address

1233 8TH ST
NEW ORLEANS LA
70115-3332
US

V. Phone/Fax

Practice location:
  • Phone: 504-899-9045
  • Fax: 504-895-0204
Mailing address:
  • Phone: 504-899-9045
  • Fax: 504-895-0204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberCM2128
License Number StateLA

VIII. Authorized Official

Name: MRS. LAURA JENSEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 504-899-9045