=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154442788
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOR BETTER HEALTH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/02/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 824 ELMWOOD PARK BLVD SUITE 210
-----------------------------------------------------
City | HARAHAN
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70123-3360
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-818-2525
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 824 ELMWOOD PARK BLVD SUITE 210
-----------------------------------------------------
City | HARAHAN
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70123-3360
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-818-2525
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO, BUSINESS MANAGER
-----------------------------------------------------
Name | MR. JAMES K HAM JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 504-818-2525
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 22145
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------