Provider Demographics
NPI:1730214214
Name:CATHOLIC CHARITIES ARCHDIOCESE OF NEW ORLEANS
Entity type:Organization
Organization Name:CATHOLIC CHARITIES ARCHDIOCESE OF NEW ORLEANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-885-1141
Mailing Address - Street 1:1000 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113
Mailing Address - Country:US
Mailing Address - Phone:504-885-1141
Mailing Address - Fax:504-885-1519
Practice Address - Street 1:921 ARIS AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2207
Practice Address - Country:US
Practice Address - Phone:504-837-6346
Practice Address - Fax:504-837-6235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1386154Medicaid