Provider Demographics
NPI:1164646568
Name:THE NEW Y OU REINTEGRATION P ROJECT, INC
Entity type:Organization
Organization Name:THE NEW Y OU REINTEGRATION P ROJECT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELISKA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ETIENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-769-4611
Mailing Address - Street 1:1442 KING WALL DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-3231
Mailing Address - Country:US
Mailing Address - Phone:225-769-4611
Mailing Address - Fax:
Practice Address - Street 1:1442 KING WALL DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-3231
Practice Address - Country:US
Practice Address - Phone:225-769-4611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11767251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1623881Medicaid
LA1776122Medicaid