=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417155995
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVOCATES FOR JUVENILE AND ADULT RIGHTS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2007
-----------------------------------------------------
Last Update Date | 11/07/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3909 4TH ST
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70125-3012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-309-8613
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1688
-----------------------------------------------------
City | LA PLACE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70069-1688
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-309-8613
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROGRAM DIRECTOR
-----------------------------------------------------
Name | KEVIN PIERRE MORRIS
-----------------------------------------------------
Credential | BA
-----------------------------------------------------
Telephone | 504-244-1234
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320600000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number | 11710
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------