Provider Demographics
NPI:1386004778
Name:JENCARE NEIGHBORHOOD MEDICAL CENTERS
Entity type:Organization
Organization Name:JENCARE NEIGHBORHOOD MEDICAL CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHENMED - CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-363-2749
Mailing Address - Street 1:1918 WILLIAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062-6232
Mailing Address - Country:US
Mailing Address - Phone:504-256-5693
Mailing Address - Fax:504-471-4873
Practice Address - Street 1:1918 WILLIAMS BLVD
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-6232
Practice Address - Country:US
Practice Address - Phone:504-256-5693
Practice Address - Fax:504-471-4873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4219261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health