Healthcare Provider Details

I. General information

NPI: 1497960231
Provider Name (Legal Business Name): SERENITY HOMES OF NEW ORLEANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 GENERAL DEGAULLE DR SUITE3023
NEW ORLEANS LA
70114-6757
US

IV. Provider business mailing address

3520 GENERAL DEGAULLE DR SUITE3023
NEW ORLEANS LA
70114-6757
US

V. Phone/Fax

Practice location:
  • Phone: 504-362-4663
  • Fax: 504-362-4676
Mailing address:
  • Phone: 504-362-4663
  • Fax: 504-362-4676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number5076
License Number StateLA

VIII. Authorized Official

Name: MRS. YVETTE BROWN JACOBS
Title or Position: CEO
Credential: 08061955
Phone: 504-362-4663