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General NPI Number Information
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NPI Number | 1366573115
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Entity Type | Organization
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Legal Business Name | CROSSROADS LA. INC.
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3719 GENERAL DEGAULLE DR
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City | NEW ORLEANS
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State | LA
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Zip | 70114-8205
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Country | US
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Telephone | 504-366-1828
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Fax | 504-366-1867
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Provider Business Mailing Address
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Address Line | 625 OLIVIER ST
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City | NEW ORLEANS
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State | LA
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Zip | 70114-1046
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Country | US
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Telephone | 504-366-1828
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Fax | 504-366-1867
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BEVERLY DUNCAN
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Credential |
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Telephone | 504-366-1828
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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 | 10209
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License Number State | LA
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