Provider Demographics
NPI:1104256957
Name:INFINITE SOLUTIONS FOR MENTAL WELLNESS
Entity type:Organization
Organization Name:INFINITE SOLUTIONS FOR MENTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-768-6950
Mailing Address - Street 1:3900 N CAUSEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1746
Mailing Address - Country:US
Mailing Address - Phone:985-768-6950
Mailing Address - Fax:504-208-9525
Practice Address - Street 1:3900 N CAUSEWAY BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1746
Practice Address - Country:US
Practice Address - Phone:985-768-6950
Practice Address - Fax:504-208-9525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2896251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health