MEDICARE: CRESCENT CITY BEHAVIORAL AND FAMILY SERVICES

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1720539455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT CITY BEHAVIORAL AND FAMILY SERVICES

Provider Business Mailing Address
First Line	:	2204 MILAN ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-5452
Country	:	US
Telephone Number	:	504-266-6718
Fax Number	:

Provider Business Practice Location Address
First Line	:	2204 MILAN ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-5452
Country	:	US
Telephone Number	:	504-266-6718
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ASHLEY JONES
Credential	:
Telephone Number	:	504-266-6718

Provider Enumeration Date	:	10/18/2016
Last Update Date	:	10/18/2016

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