Healthcare Provider Details

I. General information

NPI: 1669997698
Provider Name (Legal Business Name): FLEUR DES MAISONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2223 FRANKLIN AVE
NEW ORLEANS LA
70117-6929
US

IV. Provider business mailing address

PO BOX 870755
NEW ORLEANS LA
70187-0755
US

V. Phone/Fax

Practice location:
  • Phone: 484-493-6652
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHEL JACKSON
Title or Position: MANAGER
Credential: MA.ED.CRMJ
Phone: 504-799-7337