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General NPI Number Information
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NPI Number | 1427613371
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Entity Type | Individual
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Provider Name | LISA WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 05/07/2019
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Provider Practice Location Address
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Address Line | 1202 ST. MAURICE AVE
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City | NEW ORLEANS
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State | LA
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Zip | 70117-7011
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Country | US
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Telephone | 504-319-7792
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Fax |
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Provider Business Mailing Address
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Address Line | 8900 TILFORD RD
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City | NEW ORLEANS
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State | LA
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Zip | 70127-2930
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Country | US
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Telephone | 504-319-7792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | LA
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