MEDICARE: NEW ORLEANS ADOLESCENT HOSPITAL

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	283Q00000X	Psychiatric Hospital	263	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538170824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW ORLEANS ADOLESCENT HOSPITAL

Provider Business Mailing Address
First Line	:	210 STATE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-5735
Country	:	US
Telephone Number	:	504-897-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 STATE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-5735
Country	:	US
Telephone Number	:	504-897-3400
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. SHELBY PRICE
Credential	:	LCSW
Telephone Number	:	504-897-4615

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	08/22/2020

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Directions to “NEW ORLEANS ADOLESCENT HOSPITAL ” Practice Location

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