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General NPI Number Information
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NPI Number | 1962538819
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Entity Type | Organization
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Legal Business Name | GULF COAST TEACHING FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 1300 JACKSON ST
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City | ALEXANDRIA
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State | LA
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Zip | 71301-6929
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Country | US
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Telephone | 318-448-1801
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Fax | 318-448-1841
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Provider Business Mailing Address
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Address Line | 2400 EDENBORN AVE
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City | METAIRIE
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State | LA
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Zip | 70001-1817
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Country | US
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Telephone | 504-831-6561
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Fax | 504-835-3156
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLIE GREEN
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Credential | MPA
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Telephone | 504-831-6561
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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 | 11739
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License Number State | LA
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