MEDICARE: THE NEW YOU REINTEGRATION PROJECT

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	372600000X	Adult Companion

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	:	1932393477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NEW YOU REINTEGRATION PROJECT

Provider Business Mailing Address
First Line	:	7354 ALBERTA DR STE D
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4192
Country	:	US
Telephone Number	:	225-769-4611
Fax Number	:	225-769-4601

Provider Business Practice Location Address
First Line	:	7354 ALBERTA DR STE D
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4192
Country	:	US
Telephone Number	:	225-769-4611
Fax Number	:	225-769-4601

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ELISKA F ETIENNE
Credential	:
Telephone Number	:	225-769-4611

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	08/28/2007

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Directions to “THE NEW YOU REINTEGRATION PROJECT ” Practice Location

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