Provider Demographics
NPI:1518308634
Name:PYRAMID RESOURCES WELLNESS INSTITUTE
Entity Type:Organization
Organization Name:PYRAMID RESOURCES WELLNESS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOGILLES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-827-2708
Mailing Address - Street 1:3330 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6206
Mailing Address - Country:US
Mailing Address - Phone:504-827-2708
Mailing Address - Fax:504-827-2715
Practice Address - Street 1:3330 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6206
Practice Address - Country:US
Practice Address - Phone:504-827-2708
Practice Address - Fax:504-827-2715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health