Healthcare Provider Details

I. General information

NPI: 1427368117
Provider Name (Legal Business Name): CRESCENT CITY ADULT DAY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 HOLMES BLVD SUITE D
TERRYTOWN LA
70056-2591
US

IV. Provider business mailing address

1017 WILLIAM DR
SLIDELL LA
70460-3992
US

V. Phone/Fax

Practice location:
  • Phone: 504-367-3580
  • Fax:
Mailing address:
  • Phone: 504-367-3580
  • Fax: 594-367-3579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOLE TURNER
Title or Position: DIRECTOR
Credential:
Phone: 985-707-3758