Healthcare Provider Details

I. General information

NPI: 1114554342
Provider Name (Legal Business Name): GOODNEWS CHURCH AND CARE MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 RICHLAND RD
NEW ORLEANS LA
70114-1860
US

IV. Provider business mailing address

1525 RICHLAND RD
NEW ORLEANS LA
70114-1860
US

V. Phone/Fax

Practice location:
  • Phone: 504-513-1738
  • Fax:
Mailing address:
  • Phone: 405-923-4651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number
License Number State

VIII. Authorized Official

Name: MR. ELVIN DEWAYNE BROWN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MBA/MHA
Phone: 504-513-1738