Provider Demographics
NPI:1114590858
Name:SPA L'EAU DE NOUVELLE ORLEANS
Entity Type:Organization
Organization Name:SPA L'EAU DE NOUVELLE ORLEANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:POREE
Authorized Official - Last Name:JUNIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-704-8522
Mailing Address - Street 1:1985 BARATARIA BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4255
Mailing Address - Country:US
Mailing Address - Phone:504-704-8522
Mailing Address - Fax:
Practice Address - Street 1:1985 BARATARIA BLVD STE C
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4255
Practice Address - Country:US
Practice Address - Phone:504-704-8522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies