MEDICARE: IN THIS TOGETHER, 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	251B00000X	Case Management Agency	CM 2324	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

General Provider Information

NPI Number	:	1790964542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN THIS TOGETHER, INC.

Provider Business Mailing Address
First Line	:	1661 CANAL ST
Second Line	:	SUITE 3107
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2861
Country	:	US
Telephone Number	:	504-962-3245
Fax Number	:	504-962-3246

Provider Business Practice Location Address
First Line	:	1661 CANAL ST
Second Line	:	SUITE 3107
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2861
Country	:	US
Telephone Number	:	504-962-3245
Fax Number	:	504-962-3246

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MICHAEL HICKERSON
Credential	:	MSW
Telephone Number	:	504-962-3245

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	10/29/2007

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