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General NPI Number Information
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NPI Number | 1821523226
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Entity Type | Organization
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Legal Business Name | CRESCENT CITY FACEDOWN RECOVERY SYSTEMS, LLC
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Dates
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Enumeration Date | 04/24/2017
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 1530 LAPALCO BLVD SUITE 21
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City | HARVEY
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State | LA
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Zip | 70058-5739
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Country | US
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Telephone | 504-442-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 123 AVALON PL
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City | HAHNVILLE
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State | LA
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Zip | 70057-2015
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Country | US
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Telephone | 504-444-3389
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. HENRY NUSS
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Credential |
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Telephone | 504-442-9050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | DME.000824
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License Number State | LA
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