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General NPI Number Information
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NPI Number | 1386703312
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Entity Type | Organization
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Legal Business Name | EASTER SEALS LOUISIANA
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 305 BARONNE ST SUITE 400
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City | NEW ORLEANS
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State | LA
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Zip | 70112-1624
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Country | US
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Telephone | 504-523-7325
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Fax | 504-523-3465
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Provider Business Mailing Address
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Address Line | 305 BARONNE ST SUITE 400
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City | NEW ORLEANS
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State | LA
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Zip | 70112-1624
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Country | US
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Telephone | 504-523-7325
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Fax | 504-523-3465
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. DANIEL UNDERWOOD
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Credential |
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Telephone | 504-523-7325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | CM4135
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License Number State | LA
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