Provider Demographics
NPI:1346721255
Name:NOTRE DAME HEALTH SYSTEM
Entity Type:Organization
Organization Name:NOTRE DAME HEALTH SYSTEM
Other - Org Name:NOTRE DAME HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:TULLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-227-3600
Mailing Address - Street 1:1000 HOWARD AVE FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-1903
Mailing Address - Country:US
Mailing Address - Phone:504-227-3600
Mailing Address - Fax:504-227-3511
Practice Address - Street 1:1000 HOWARD AVE FL 10
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113
Practice Address - Country:US
Practice Address - Phone:504-227-3600
Practice Address - Fax:504-227-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1911682Medicaid
LA1930041Medicaid