Provider Demographics
NPI:1194118745
Name:PROVIDENCE COMMUNITY HOUSING
Entity type:Organization
Organization Name:PROVIDENCE COMMUNITY HOUSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-821-7222
Mailing Address - Street 1:1050 S JEFFERSON DAVIS PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-1200
Mailing Address - Country:US
Mailing Address - Phone:504-821-7222
Mailing Address - Fax:
Practice Address - Street 1:2200 LAFITTE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5058
Practice Address - Country:US
Practice Address - Phone:504-827-9963
Practice Address - Fax:504-827-5432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management