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General NPI Number Information
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NPI Number | 1134487390
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Entity Type | Organization
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Legal Business Name | FAMILY AGENDA COMMUNITY CENTER
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 1727 HOLIDAY DR
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City | NEW ORLEANS
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State | LA
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Zip | 70114-3453
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Country | US
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Telephone | 504-452-0881
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Fax |
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Provider Business Mailing Address
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Address Line | 1727 HOLIDAY DR
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City | NEW ORLEANS
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State | LA
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Zip | 70114-3453
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Country | US
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Telephone | 504-452-0881
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR / PRESIDENT
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Name | MRS. KIMBERLY FRANKLIN CHILES
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Credential | MA (INTERN)
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Telephone | 504-452-0881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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