MEDICARE: GALILEE HOUSING INITIATIVE & COMMUNITY DEVELOPMENT CORPORATION

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	251V00000X	Voluntary or Charitable Agency		LA

General Provider Information

NPI Number	:	1932418712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALILEE HOUSING INITIATIVE & COMMUNITY DEVELOPMENT CORPORATION

Provider Business Mailing Address
First Line	:	726 JACKSON AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4938
Country	:	US
Telephone Number	:	504-523-1413
Fax Number	:	504-523-1324

Provider Business Practice Location Address
First Line	:	726 JACKSON AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4938
Country	:	US
Telephone Number	:	504-523-1413
Fax Number	:	504-523-1324

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. CAROLYN CRAFT WILLIAMS
Credential	:
Telephone Number	:	504-523-1413

Provider Enumeration Date	:	09/28/2010
Last Update Date	:	09/28/2010

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