Provider Demographics
NPI:1104190636
Name:CHILD & ADOLESCENT BEHAVIORAL HEALTH SYSTEM/WEST BANK CLINIC
Entity type:Organization
Organization Name:CHILD & ADOLESCENT BEHAVIORAL HEALTH SYSTEM/WEST BANK CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GILDA
Authorized Official - Middle Name:ARMSTRONG
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:225-252-9107
Mailing Address - Street 1:4422 GENERAL MEYER AVE
Mailing Address - Street 2:100
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-3588
Mailing Address - Country:US
Mailing Address - Phone:504-361-6092
Mailing Address - Fax:504-361-6250
Practice Address - Street 1:4422 GENERAL MEYER AVE
Practice Address - Street 2:100
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-3588
Practice Address - Country:US
Practice Address - Phone:504-361-6092
Practice Address - Fax:504-361-6250
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DHH/OBH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-01
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health