1417155995 NPI number — ADVOCATES FOR JUVENILE AND ADULT RIGHTS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417155995 NPI number — ADVOCATES FOR JUVENILE AND ADULT RIGHTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVOCATES FOR JUVENILE AND ADULT RIGHTS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417155995
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1688
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA PLACE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70069-1688
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-309-8613
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3909 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70125-3012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-309-8613
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MORRIS
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
PIERRE
Authorized Official Title or Position:
PROGRAM DIRECTOR
Authorized Official Telephone Number:
504-244-1234

Provider Taxonomy Codes

  • Taxonomy code: 320600000X , with the licence number:  11710 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1470431 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1542920 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1539791 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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