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General NPI Number Information
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NPI Number | 1174522734
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Entity Type | Organization
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Legal Business Name | ATRIUM 6555 TENANT, LLC
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 6555 PARK MANOR DR
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City | METAIRIE
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State | LA
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Zip | 70003-3906
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Country | US
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Telephone | 504-454-6635
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Fax | 504-454-6655
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Provider Business Mailing Address
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Address Line | 6555 PARK MANOR DR
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City | METAIRIE
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State | LA
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Zip | 70003-3906
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Country | US
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Telephone | 504-454-6635
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Fax | 504-454-6655
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Authorized Official
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Title or Position | COO
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Name | MR. ALEX PALEY
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Credential |
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Telephone | 914-390-4363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 11264
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License Number State | LA
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