MEDICARE: CRESCENT CITY SCHOOLS

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
1	261QS1000X	Student Health Clinic/Center

General Provider Information

NPI Number	:	1073818274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT CITY SCHOOLS

Provider Business Mailing Address
First Line	:	200 BROADWAY ST
Second Line	:	SUITE 108
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-3557
Country	:	US
Telephone Number	:	504-234-4528
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 BROADWAY ST
Second Line	:	SUITE 108
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-3557
Country	:	US
Telephone Number	:	504-234-4528
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. KATE MEHOK
Credential	:
Telephone Number	:	504-234-4528

Provider Enumeration Date	:	01/19/2011
Last Update Date	:	01/19/2011

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Directions to “CRESCENT CITY SCHOOLS ” Practice Location

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