Healthcare Provider Details

I. General information

NPI: 1790089381
Provider Name (Legal Business Name): CATHOLIC CHARITIES ARCHDIOCESE OF NEW ORLEANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2010
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HOWARD AVE STE. 1000
NEW ORLEANS LA
70113-1924
US

IV. Provider business mailing address

1000 HOWARD AVE STE. 1000
NEW ORLEANS LA
70113-1924
US

V. Phone/Fax

Practice location:
  • Phone: 504-523-3755
  • Fax: 504-596-3098
Mailing address:
  • Phone: 504-523-3755
  • Fax: 504-596-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number2924
License Number StateLA

VIII. Authorized Official

Name: MR. GORDON R. WADGE
Title or Position: CO-PRESIDENT/CEO
Credential:
Phone: 504-523-3755