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General NPI Number Information
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NPI Number | 1821116724
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Entity Type | Organization
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Legal Business Name | EASTER SEALS LOUISIANA
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4937 HEARST ST
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City | METAIRIE
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State | LA
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Zip | 70001-1120
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Country | US
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Telephone | 504-889-1987
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 COMMON ST SUITE 2000
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City | NEW ORLEANS
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State | LA
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Zip | 70112-2401
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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 | PRESIDENT CEO
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Name | DANIEL UNDERWOOD
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Credential |
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Telephone | 504-523-7325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | LA
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