Provider Demographics
NPI:1245557420
Name:NOLA BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:NOLA BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:DOCKERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-477-7900
Mailing Address - Street 1:3501 N CAUSEWAY BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3618
Mailing Address - Country:US
Mailing Address - Phone:919-477-7900
Mailing Address - Fax:919-794-5662
Practice Address - Street 1:3501 N CAUSEWAY BLVD STE 300
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3618
Practice Address - Country:US
Practice Address - Phone:919-477-7900
Practice Address - Fax:919-794-5662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health