Provider Demographics
NPI:1073083341
Name:LANGNIAPPE CORP
Entity Type:Organization
Organization Name:LANGNIAPPE CORP
Other - Org Name:LISA DE GENESTE
Other - Org Type:Other Name
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE GENESTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-299-4344
Mailing Address - Street 1:4915 N HARBOR ISLES DR
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-5225
Mailing Address - Country:US
Mailing Address - Phone:917-566-5628
Mailing Address - Fax:
Practice Address - Street 1:915 MIDDLE RIVER DR STE 307
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-3560
Practice Address - Country:US
Practice Address - Phone:917-566-5628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-29
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)