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NPI Code Detail

MEDICARE: GULF COAST TEACHING FAMILY SERVICES, INC.

MEDICARE: GULF COAST TEACHING FAMILY SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1GCTFSLC1OTHERLAMST SERVICES

General Provider Information

NPI Number : 1013173913
Entity Type Code : Organization
Provider Name (Legal Business Name) : GULF COAST TEACHING FAMILY SERVICES, INC.
Provider Business Mailing Address
First Line : 2400 EDENBORN AVE
Second Line :
City : METAIRIE
State : LA
Zip : 70001-1817
Country : US
Telephone Number : 504-831-6561
Fax Number : 504-835-3156
Provider Business Practice Location Address
First Line : 700 PUJO ST STE A
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-4378
Country : US
Telephone Number : 337-436-6622
Fax Number : 337-436-4403
Authorized Official
Title or Position : CEO
Name : MR. WILLIE GREEN
Credential : MPA
Telephone Number : 504-831-6561
Provider Enumeration Date : 07/31/2008
Last Update Date : 09/27/2022

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