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General NPI Number Information
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NPI Number | 1760789002
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Entity Type | Organization
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Legal Business Name | DURDEN CONSULTING SERVICES OF LA, LLC
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 2323 BAINBRIDGE ST STE B-7
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City | KENNER
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State | LA
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Zip | 70062-4108
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Country | US
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Telephone | 478-455-2092
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Fax |
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Provider Business Mailing Address
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Address Line | 5910 GA HIGHWAY 21 S UNIT 6
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City | RINCON
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State | GA
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Zip | 31326-5505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KENNEITH DURHAM
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Credential |
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Telephone | 478-455-2092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | LA
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