Provider Demographics
NPI:1023376498
Name:LSU HEALTHCARE NETWORK
Entity Type:Organization
Organization Name:LSU HEALTHCARE NETWORK
Other - Org Name:LSU BEHAVIORAL SCIENCES CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT III
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-903-9213
Mailing Address - Street 1:1340 POYDRAS ST
Mailing Address - Street 2:SUITE 1640
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-1221
Mailing Address - Country:US
Mailing Address - Phone:504-412-1100
Mailing Address - Fax:504-412-1530
Practice Address - Street 1:3450 CHESTNUT ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-2443
Practice Address - Country:US
Practice Address - Phone:504-412-1580
Practice Address - Fax:504-412-1530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LSU HEALTHCARE NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty