MEDICARE: SPIRIT OF EXCELLENCE ACADEMY, 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
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1285902577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPIRIT OF EXCELLENCE ACADEMY, INC

Provider Business Mailing Address
First Line	:	1829 CARONDELET ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-5207
Country	:	US
Telephone Number	:	504-524-8891
Fax Number	:	504-523-6149

Provider Business Practice Location Address
First Line	:	2503 WILLOW ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70113-3234
Country	:	US
Telephone Number	:	504-373-6230
Fax Number	:	504-891-6919

Authorized Official
Title or Position	:	CEO/PRINCIPAL
Name	:	MISS EILEEN WILLIAMS
Credential	:
Telephone Number	:	504-373-6230

Provider Enumeration Date	:	12/01/2011
Last Update Date	:	12/01/2011

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Directions to “SPIRIT OF EXCELLENCE ACADEMY, INC ” Practice Location

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