Provider Demographics
NPI:1609009570
Name:VOLUNTEERS OF AMERICA SOUTHEAST LOUISIANA
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA SOUTHEAST LOUISIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-482-2130
Mailing Address - Street 1:4152 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5941
Mailing Address - Country:US
Mailing Address - Phone:504-482-2130
Mailing Address - Fax:504-482-1922
Practice Address - Street 1:4152 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5941
Practice Address - Country:US
Practice Address - Phone:504-482-2130
Practice Address - Fax:504-482-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6786253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1884677Medicaid