=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629628987
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAVID 3.0 CONSULTING GROUP LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2019
-----------------------------------------------------
Last Update Date | 02/16/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1799 STUMPF BLVD # 7-2A
-----------------------------------------------------
City | TERRYTOWN
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70056-3950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-400-3448
-----------------------------------------------------
Fax | 504-617-7778
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3030 WABASH ST
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70114-6532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-400-3448
-----------------------------------------------------
Fax | 504-617-7778
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | URSULA NEWELL DAVIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 504-400-3448
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------