Provider Demographics
NPI:1205282167
Name:ACCESS HEALTH LOUISIANA
Entity type:Organization
Organization Name:ACCESS HEALTH LOUISIANA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KEISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-575-3712
Mailing Address - Street 1:1401 W ESPLANADE AVE
Mailing Address - Street 2:SUITE 108-A
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2845
Mailing Address - Country:US
Mailing Address - Phone:985-307-1600
Mailing Address - Fax:504-575-3691
Practice Address - Street 1:2900 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-4605
Practice Address - Country:US
Practice Address - Phone:504-575-3712
Practice Address - Fax:504-575-3691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA115321041C0700X
LAMD2060292084P0800X
LAMD023712207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty