Provider Demographics
NPI:1518043538
Name:ENHANCED HEALTH TREATMENT CENTER, INC.
Entity Type:Organization
Organization Name:ENHANCED HEALTH TREATMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CNS
Authorized Official - Phone:504-242-1577
Mailing Address - Street 1:8070 CROWDER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-1063
Mailing Address - Country:US
Mailing Address - Phone:504-242-1577
Mailing Address - Fax:504-333-6326
Practice Address - Street 1:8070 CROWDER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-1063
Practice Address - Country:US
Practice Address - Phone:504-242-1577
Practice Address - Fax:504-333-6326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA194643Medicare ID - Type Unspecified