Provider Demographics
NPI:1285155515
Name:ENCOUNTER MEDICAL GROUP, P.C. DBA TWO DREAMS NEW ORLEANS
Entity type:Organization
Organization Name:ENCOUNTER MEDICAL GROUP, P.C. DBA TWO DREAMS NEW ORLEANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MILTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:504-510-2331
Mailing Address - Street 1:1820 ST. CHARLES AVE.
Mailing Address - Street 2:SUITE 212
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130
Mailing Address - Country:US
Mailing Address - Phone:504-510-2331
Mailing Address - Fax:504-342-2877
Practice Address - Street 1:1820 ST. CHARLES AVE.
Practice Address - Street 2:SUITE 212
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130
Practice Address - Country:US
Practice Address - Phone:504-510-2331
Practice Address - Fax:504-342-2877
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOUNTER MEDICAL GROUP, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-27
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203783286324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility