Healthcare Provider Details

I. General information

NPI: 1023263068
Provider Name (Legal Business Name): DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 01/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4164 CANAL ST ADMINISTRATIVE OFFICES
NEW ORLEANS LA
70119-5941
US

IV. Provider business mailing address

PO BOX 970
HARVEY LA
70059-0970
US

V. Phone/Fax

Practice location:
  • Phone: 504-482-2080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GRIFFIN
Title or Position: CEO
Credential:
Phone: 504-482-2080