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General NPI Number Information
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NPI Number | 1790620854
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Entity Type | Organization
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Legal Business Name | SUI GENERIS SANCTUM SANCTORIS
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 615 PERE ANTOINE ALY
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City | NEW ORLEANS
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State | LA
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Zip | 70116-3234
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Country | US
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Telephone | 225-333-4424
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Fax |
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Provider Business Mailing Address
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Address Line | 4342 RUE DE BELLE MAISON APT D
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City | BATON ROUGE
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State | LA
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Zip | 70809-7218
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Country | US
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Telephone | 225-333-4424
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Fax |
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Authorized Official
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Title or Position | MASSARIUS
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Name | DR. ALEA CHARRON HENTON
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Credential | ACHE,MH,CHT
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Telephone | 225-333-4424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101200000X
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Taxonomy Name | Drama Therapist
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License Number |
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License Number State |
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