Provider Demographics
NPI:1912382177
Name:VOLUNTEERS OF AMERICA SOUTHEAST LOUISIANA, INC.
Entity type:Organization
Organization Name:VOLUNTEERS OF AMERICA SOUTHEAST LOUISIANA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP OF ENTERPRISE & ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-486-8674
Mailing Address - Street 1:4152 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5941
Mailing Address - Country:US
Mailing Address - Phone:504-482-2130
Mailing Address - Fax:504-482-1922
Practice Address - Street 1:1990 SURGI DR STE A
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-2234
Practice Address - Country:US
Practice Address - Phone:985-612-1067
Practice Address - Fax:985-626-5158
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VOLUNTEERS OF AMERICA SOUTHEAST LOUISIANA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-29
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA556224171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty