Provider Demographics
NPI:1144403353
Name:HUMAN SERVICE MANAGEMENT AND INVESTMENT, LLC
Entity Type:Organization
Organization Name:HUMAN SERVICE MANAGEMENT AND INVESTMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-655-2629
Mailing Address - Street 1:2112 BELLE CHASSE HWY # 11-240
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7105
Mailing Address - Country:US
Mailing Address - Phone:504-655-2629
Mailing Address - Fax:504-368-0262
Practice Address - Street 1:1401 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-3256
Practice Address - Country:US
Practice Address - Phone:504-655-2629
Practice Address - Fax:504-368-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LASIL 20015305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization