1629342118 NPI number — EARLY CHILDHOOD SUPPORT & SERVICES - ORLEANS

Table of content: EMMANUEL JESUROBO OSEMWEGIE NP (NPI 1346750775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629342118 NPI number — EARLY CHILDHOOD SUPPORT & SERVICES - ORLEANS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EARLY CHILDHOOD SUPPORT & SERVICES - ORLEANS
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:
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:
1629342118
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3801 CANAL ST STE 211
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70119-6084
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-483-1821
Provider Business Mailing Address Fax Number:
504-483-1822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3801 CANAL ST STE 211
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:
70119-6084
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-483-1821
Provider Business Practice Location Address Fax Number:
504-483-1822
Provider Enumeration Date:
02/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
WASHINGTON
Authorized Official First Name:
STACIE
Authorized Official Middle Name:
BARCONEY
Authorized Official Title or Position:
PROGRAM DIRECTOR
Authorized Official Telephone Number:
504-483-1821

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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