Healthcare Provider Details

I. General information

NPI: 1205992997
Provider Name (Legal Business Name): SIRI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 SAINT PHILIP ST
NEW ORLEANS LA
70116-2116
US

IV. Provider business mailing address

1722 SAINT PHILIP ST
NEW ORLEANS LA
70116-2117
US

V. Phone/Fax

Practice location:
  • Phone: 504-220-8786
  • Fax: 713-490-2683
Mailing address:
  • Phone: 504-220-8786
  • Fax: 713-490-2683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. TOBY CHALONE BRANDEN
Title or Position: BOARD SECRETARY
Credential:
Phone: 504-520-0125